Provider Demographics
NPI:1619075835
Name:BOAKYE, KWADWO (MD)
Entity Type:Individual
Prefix:DR
First Name:KWADWO
Middle Name:
Last Name:BOAKYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 MCGRAW AVE
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7967
Mailing Address - Country:US
Mailing Address - Phone:718-892-2390
Mailing Address - Fax:718-892-8090
Practice Address - Street 1:1950 MCGRAW AVENUE
Practice Address - Street 2:SUITE 1F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-9767
Practice Address - Country:US
Practice Address - Phone:718-892-2390
Practice Address - Fax:718-892-8090
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY142892207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA96884Medicare UPIN
NY02D43YRRV1Medicare PIN