Provider Demographics
NPI:1356486914
Name:AWUAH, KWAME BONSU (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:KWAME
Middle Name:BONSU
Last Name:AWUAH
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 E 95TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-2636
Mailing Address - Country:US
Mailing Address - Phone:718-417-2535
Mailing Address - Fax:
Practice Address - Street 1:89 PORTER AVE # 111
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-1417
Practice Address - Country:US
Practice Address - Phone:718-417-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009643-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400012462Medicare PIN