Provider Demographics
NPI:1538440938
Name:DR FRANKLIN A AYEW PHYSICIAN PC
Entity type:Organization
Organization Name:DR FRANKLIN A AYEW PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:ASARE
Authorized Official - Last Name:AYEW
Authorized Official - Suffix:
Authorized Official - Credentials:MB CHB
Authorized Official - Phone:845-356-1430
Mailing Address - Street 1:265 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3702
Mailing Address - Country:US
Mailing Address - Phone:845-356-1430
Mailing Address - Fax:845-425-2174
Practice Address - Street 1:24 WAGON WHEEL DR
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1338
Practice Address - Country:US
Practice Address - Phone:845-323-4971
Practice Address - Fax:845-425-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185887261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01277398Medicaid
NYF21214Medicare UPIN