Provider Demographics
NPI:1467944595
Name:OPOKU GYAMFI, MARTIN (ND)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:OPOKU GYAMFI
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 BERLIN TPKE UNIT B
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-3228
Mailing Address - Country:US
Mailing Address - Phone:860-829-0707
Mailing Address - Fax:860-829-0606
Practice Address - Street 1:1265 BERLIN TPKE UNIT B
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-3228
Practice Address - Country:US
Practice Address - Phone:860-829-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT624175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath