Provider Demographics
NPI:1205150315
Name:BOATENG-DUAH, AKWASI (DPT)
Entity type:Individual
Prefix:
First Name:AKWASI
Middle Name:
Last Name:BOATENG-DUAH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 UNDERCLIFF AVE
Mailing Address - Street 2:APT.# 116
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-7172
Mailing Address - Country:US
Mailing Address - Phone:917-239-5752
Mailing Address - Fax:
Practice Address - Street 1:799 E GUN HILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-6107
Practice Address - Country:US
Practice Address - Phone:347-843-8008
Practice Address - Fax:347-843-8009
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist