Provider Demographics
NPI:1073929626
Name:GYAMERAH, KOFI OPUSUO (RN)
Entity Type:Individual
Prefix:MR
First Name:KOFI
Middle Name:OPUSUO
Last Name:GYAMERAH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MCFADDEN CIR
Mailing Address - Street 2:PH
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-6369
Mailing Address - Country:US
Mailing Address - Phone:646-305-1029
Mailing Address - Fax:
Practice Address - Street 1:38 MCFADDEN CIR
Practice Address - Street 2:PH
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6369
Practice Address - Country:US
Practice Address - Phone:646-305-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685704-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse