Provider Demographics
NPI:1891050647
Name:AMNAWAH, JOSEPH (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:AMNAWAH
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 CAPITOLIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2610
Mailing Address - Country:US
Mailing Address - Phone:917-459-6393
Mailing Address - Fax:
Practice Address - Street 1:400 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-608-5900
Practice Address - Fax:631-396-0382
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402651363LP0808X, 363LP0808X
NY402651363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health