Provider Demographics
NPI:1538325535
Name:TWENEBOAH, OSEI K (RADIOLOGY TECHNOLOGI)
Entity type:Individual
Prefix:
First Name:OSEI
Middle Name:K
Last Name:TWENEBOAH
Suffix:
Gender:M
Credentials:RADIOLOGY TECHNOLOGI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HUGUENOT ST APT 908
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6395
Mailing Address - Country:US
Mailing Address - Phone:914-813-1530
Mailing Address - Fax:
Practice Address - Street 1:255 HUGUENOT ST APT 908
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6395
Practice Address - Country:US
Practice Address - Phone:914-813-1530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY398678247100000X
CT005359247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist