Provider Demographics
NPI:1346545456
Name:APEDO, AKOFA F
Entity Type:Individual
Prefix:
First Name:AKOFA
Middle Name:F
Last Name:APEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 BREN RD E
Mailing Address - Street 2:MAIL ROUTE MN 008-B213
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9664
Mailing Address - Country:US
Mailing Address - Phone:845-234-8977
Mailing Address - Fax:
Practice Address - Street 1:121 E CLARKE PL
Practice Address - Street 2:APT 4D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-7653
Practice Address - Country:US
Practice Address - Phone:917-400-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541776-1163WH0200X
NYF340763363LG0600X
NYF305282-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology