Provider Demographics
NPI:1386825388
Name:MENSAH, LAURENCE DELALI (RPH)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:DELALI
Last Name:MENSAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3806
Mailing Address - Country:US
Mailing Address - Phone:212-795-3218
Mailing Address - Fax:212-543-0288
Practice Address - Street 1:1033 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3806
Practice Address - Country:US
Practice Address - Phone:212-795-3218
Practice Address - Fax:212-543-0288
Is Sole Proprietor?:No
Enumeration Date:2007-11-18
Last Update Date:2007-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist