Provider Demographics
NPI:1154644995
Name:BOATENG, ENOCH KWASI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ENOCH
Middle Name:KWASI
Last Name:BOATENG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SERENE LN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5689
Mailing Address - Country:US
Mailing Address - Phone:917-291-4844
Mailing Address - Fax:
Practice Address - Street 1:10 SERENE LN
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5689
Practice Address - Country:US
Practice Address - Phone:917-291-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439328183500000X
NJ28RIO2993900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist