Provider Demographics
NPI:1093036436
Name:ACHEAMPONG, KWAKYE ERIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:KWAKYE
Middle Name:ERIC
Last Name:ACHEAMPONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FOREST GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-6802
Mailing Address - Country:US
Mailing Address - Phone:732-970-8362
Mailing Address - Fax:
Practice Address - Street 1:152 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1115
Practice Address - Country:US
Practice Address - Phone:732-815-9320
Practice Address - Fax:732-815-1736
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02944400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist