Provider Demographics
NPI:1497537922
Name:AIDOO (KYERE), AKOSUA OPONWAA
Entity Type:Individual
Prefix:
First Name:AKOSUA
Middle Name:OPONWAA
Last Name:AIDOO (KYERE)
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AKOSUA
Other - Middle Name:OPONWAA
Other - Last Name:KYERE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1161 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-5377
Mailing Address - Country:US
Mailing Address - Phone:718-581-9477
Mailing Address - Fax:
Practice Address - Street 1:6424 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3729
Practice Address - Country:US
Practice Address - Phone:212-687-7464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY828787163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse