Provider Demographics
NPI:1346583606
Name:OWUSU, DEBORAH AGYEIWAAH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:AGYEIWAAH
Last Name:OWUSU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RADFORD ST
Mailing Address - Street 2:APT. 5E
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3049
Mailing Address - Country:US
Mailing Address - Phone:646-464-3737
Mailing Address - Fax:
Practice Address - Street 1:125 RADFORD ST
Practice Address - Street 2:APT. 5E
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3049
Practice Address - Country:US
Practice Address - Phone:646-464-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313461-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse