Provider Demographics
NPI:1871845016
Name:AMO MENSAH, YAW
Entity Type:Individual
Prefix:MR
First Name:YAW
Middle Name:
Last Name:AMO MENSAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36B ALDRICH DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3305
Mailing Address - Country:US
Mailing Address - Phone:718-864-5373
Mailing Address - Fax:
Practice Address - Street 1:36B ALDRICH DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3305
Practice Address - Country:US
Practice Address - Phone:718-864-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker