Provider Demographics
NPI:1518043819
Name:KWAKYE-BERKO, FRANK KWABENA (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:KWABENA
Last Name:KWAKYE-BERKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-2349
Mailing Address - Country:US
Mailing Address - Phone:716-307-8266
Mailing Address - Fax:814-723-2024
Practice Address - Street 1:1155 EAST MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7906
Practice Address - Country:US
Practice Address - Phone:570-808-7916
Practice Address - Fax:570-808-6006
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070891L207V00000X
NY217255207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019074260004Medicaid
PA194172OtherUNISON
PA0019074260002Medicaid
PA0019074260005Medicaid
PA1906897OtherBLUE SHIELD
PA0019074260003Medicaid
H00080Medicare UPIN