Provider Demographics
NPI:1376733345
Name:OSEI-TUTU, ACHIAMAH (MD)
Entity Type:Individual
Prefix:
First Name:ACHIAMAH
Middle Name:
Last Name:OSEI-TUTU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5118
Mailing Address - Country:US
Mailing Address - Phone:516-506-0025
Mailing Address - Fax:516-506-0032
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 204A
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5118
Practice Address - Country:US
Practice Address - Phone:516-506-0025
Practice Address - Fax:516-506-0032
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251302207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology