1447442587 NPI number — ANTHONY K FREMPONG-BOADU

Table of content: (NPI 1447442587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447442587 NPI number — ANTHONY K FREMPONG-BOADU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANTHONY K FREMPONG-BOADU
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447442587
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 1ST AVE
Provider Second Line Business Mailing Address:
DEPARTMENT OF NEUROSURGERY
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-6402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-263-6514
Provider Business Mailing Address Fax Number:
212-263-8225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 1ST AVE
Provider Second Line Business Practice Location Address:
SUITE 5C
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-6402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-263-6514
Provider Business Practice Location Address Fax Number:
212-263-8225
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FREMPONG-BOADU
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
NEUROSURGEON
Authorized Official Telephone Number:
212-263-6514

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  ME79239 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , with the licence number: 199352 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02039403 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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