Provider Demographics
NPI:1164806287
Name:ADJAPON-YAMOAH, TAYO (PNP)
Entity Type:Individual
Prefix:
First Name:TAYO
Middle Name:
Last Name:ADJAPON-YAMOAH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUNSET PARK CHILDREN'S HEALTH AT NYU LANGONE
Mailing Address - Street 2:5610 2ND AVE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:718-630-7249
Mailing Address - Fax:718-630-6877
Practice Address - Street 1:SUNSET PARK CHILDREN'S HEALTH AT NYU LANGONE
Practice Address - Street 2:5610 2ND AVE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-630-7249
Practice Address - Fax:718-630-6877
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP 7974363LP0200X
NY382686363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ043338Medicaid
AZ1164806287Medicare NSC