Provider Demographics
NPI:1457687394
Name:AMANKWAAH, EDWARD KWADWO (CRNA)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:KWADWO
Last Name:AMANKWAAH
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-7857
Practice Address - Fax:914-493-8439
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2011-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY542759367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400022491OtherMEDICARE