Provider Demographics
NPI:1457666000
Name:NANA YAW ASAMOAH-MENSAH, M.D.,P.C.
Entity Type:Organization
Organization Name:NANA YAW ASAMOAH-MENSAH, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:YAW
Authorized Official - Last Name:ASAMOAH-MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-587-5048
Mailing Address - Street 1:12601 BRIDOON LN
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-5828
Mailing Address - Country:US
Mailing Address - Phone:703-587-5048
Mailing Address - Fax:
Practice Address - Street 1:1140 VARNUM ST NE
Practice Address - Street 2:SUITE 205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2153
Practice Address - Country:US
Practice Address - Phone:202-269-0499
Practice Address - Fax:202-269-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0352242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC042383500Medicaid
DC190472Medicare PIN