Provider Demographics
NPI:1598961013
Name:BOAKYE, NAANA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAANA
Middle Name:
Last Name:BOAKYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SYLVAN AVENUE
Mailing Address - Street 2:305
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632
Mailing Address - Country:US
Mailing Address - Phone:201-567-7546
Mailing Address - Fax:210-567-1087
Practice Address - Street 1:140 SYLVAN AVE
Practice Address - Street 2:305
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2514
Practice Address - Country:US
Practice Address - Phone:201-567-7546
Practice Address - Fax:210-567-1087
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243859207NS0135X
NJ25MA08407300207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ213029OtherPTAN