Provider Demographics
NPI:1730220708
Name:AGYEMAN, DANSO OKOAMPA (BSC, PAC)
Entity type:Individual
Prefix:MR
First Name:DANSO
Middle Name:OKOAMPA
Last Name:AGYEMAN
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Gender:M
Credentials:BSC, PAC
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Mailing Address - Street 1:10 E 138TH ST
Mailing Address - Street 2:APT.# 9B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2001
Mailing Address - Country:US
Mailing Address - Phone:212-368-5580
Mailing Address - Fax:212-368-5580
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:RM. 12119
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-1648
Practice Address - Fax:212-939-1798
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY008907363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical