Provider Demographics
NPI:1538703954
Name:OWUSU, FRANK (PA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:OWUSU
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 165TH ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-6658
Mailing Address - Country:US
Mailing Address - Phone:646-912-2194
Mailing Address - Fax:
Practice Address - Street 1:500 E 165TH ST APT 2E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-6658
Practice Address - Country:US
Practice Address - Phone:646-912-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3737Medicaid