Provider Demographics
NPI:1376267609
Name:OFOSU-KORANTENG, SHUMUEL
Entity Type:Individual
Prefix:
First Name:SHUMUEL
Middle Name:
Last Name:OFOSU-KORANTENG
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 1:28 HEDGEROW LN
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-7904
Mailing Address - Country:US
Mailing Address - Phone:732-570-0793
Mailing Address - Fax:
Practice Address - Street 1:28 HEDGEROW LN
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-7904
Practice Address - Country:US
Practice Address - Phone:732-570-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant