Provider Demographics
NPI:1003182528
Name:AMANKWAH, LYDIA (RN)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:AMANKWAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 E 141ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2410
Mailing Address - Country:US
Mailing Address - Phone:718-401-0578
Mailing Address - Fax:
Practice Address - Street 1:677 E 141ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2410
Practice Address - Country:US
Practice Address - Phone:718-401-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605549163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool