Provider Demographics
NPI:1831846351
Name:AMPONSAH, RICHARD KWAKU (EDD, DPT, PMP)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KWAKU
Last Name:AMPONSAH
Suffix:
Gender:M
Credentials:EDD, DPT, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2872 SCARBOROUGH CIR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-8063
Mailing Address - Country:US
Mailing Address - Phone:757-550-7186
Mailing Address - Fax:
Practice Address - Street 1:2872 SCARBOROUGH CIR
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-8063
Practice Address - Country:US
Practice Address - Phone:757-550-7186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113258-01225100000X
TX2174554225200000X
NY013631-01225200000X
MDA5790225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist