Provider Demographics
NPI:1619740883
Name:BONSU, OHENEWAA A
Entity Type:Individual
Prefix:
First Name:OHENEWAA
Middle Name:A
Last Name:BONSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 TAFT RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2827
Mailing Address - Country:US
Mailing Address - Phone:201-660-2525
Mailing Address - Fax:
Practice Address - Street 1:1318 TAFT RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2827
Practice Address - Country:US
Practice Address - Phone:201-660-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY449233-1163WA0400X
NJ26NR10463300163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)