Provider Demographics
NPI:1184025934
Name:ABOAGYE, PETER K (RN)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:K
Last Name:ABOAGYE
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 1:240 MT. HOPE PLACE
Mailing Address - Street 2:APT 6D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5430
Mailing Address - Country:US
Mailing Address - Phone:646-226-3171
Mailing Address - Fax:
Practice Address - Street 1:2052 TILLOTSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1560
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685802163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse