Provider Demographics
NPI:1043510407
Name:ASAMOAH, KUMA
Entity Type:Individual
Prefix:
First Name:KUMA
Middle Name:
Last Name:ASAMOAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 DAVIDSON AVE
Mailing Address - Street 2:APT 1B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5603
Mailing Address - Country:US
Mailing Address - Phone:646-321-3169
Mailing Address - Fax:
Practice Address - Street 1:1770 DAVIDSON AVE
Practice Address - Street 2:APT 1B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5603
Practice Address - Country:US
Practice Address - Phone:646-321-3169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288250-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse