Provider Demographics
NPI:1639473762
Name:WILLIAM O BOAH MD LLP
Entity Type:Organization
Organization Name:WILLIAM O BOAH MD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AKUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-282-9690
Mailing Address - Street 1:145 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4307
Mailing Address - Country:US
Mailing Address - Phone:718-282-9690
Mailing Address - Fax:718-287-5915
Practice Address - Street 1:145 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4307
Practice Address - Country:US
Practice Address - Phone:718-282-9690
Practice Address - Fax:718-287-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242939207R00000X, 207RR0500X
NY130416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty