Provider Demographics
NPI:1427216746
Name:OFORI-BEHOME, YAW (MD)
Entity Type:Individual
Prefix:
First Name:YAW
Middle Name:
Last Name:OFORI-BEHOME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S BROADWAY STE A-4
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1762
Mailing Address - Country:US
Mailing Address - Phone:732-727-4900
Mailing Address - Fax:732-727-4902
Practice Address - Street 1:135 S BROADWAY STE A-4
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1762
Practice Address - Country:US
Practice Address - Phone:732-727-4900
Practice Address - Fax:732-727-4902
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08696000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine