Provider Demographics
NPI:1295408664
Name:GYAMFI, ANTHONY AKWASI
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:AKWASI
Last Name:GYAMFI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3308
Mailing Address - Country:US
Mailing Address - Phone:212-768-0201
Mailing Address - Fax:212-354-0988
Practice Address - Street 1:1430 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3308
Practice Address - Country:US
Practice Address - Phone:212-768-0201
Practice Address - Fax:212-354-0988
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist