Provider Demographics
NPI:1437201472
Name:MENSAH, DOREEN AKOSUA (MD)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:AKOSUA
Last Name:MENSAH
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 1:411 WEST 113TH STREET
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1703
Mailing Address - Country:US
Mailing Address - Phone:212-866-5461
Mailing Address - Fax:212-866-7706
Practice Address - Street 1:411 WEST 113TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1703
Practice Address - Country:US
Practice Address - Phone:212-866-5461
Practice Address - Fax:212-866-7706
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2591439OtherGHI PPO
NY02109644Medicaid
NY279668AOtherMAGNACARE PPO
NY201100957OtherPHCS
NY2120367OtherUNITED HEALTHCARE CHOICE
NY7086441014OtherCIGNA HMO
NY201100957OtherHORIZON
NY3C5378OtherPPO HMO
NY5850736OtherAETNA USHC PPO
NY201100957OtherMULTIPLAN
NY219161OtherHIP
NY13-4106083Other1199
NY219161-B26OtherHEALTHFIRST
NY219ABOtherEMPIRE BLUE CROSS PPO EPO
NYP2706080OtherOXFORD
NY7086441014OtherCIGNA HMO
NY201100957OtherPHCS