Provider Demographics
NPI:1922464379
Name:AMO, AKUA
Entity Type:Individual
Prefix:
First Name:AKUA
Middle Name:
Last Name:AMO
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 1:1972 MARIANNE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5428
Mailing Address - Country:US
Mailing Address - Phone:908-884-3373
Mailing Address - Fax:908-982-4344
Practice Address - Street 1:1972 MARIANNE WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5428
Practice Address - Country:US
Practice Address - Phone:908-884-3373
Practice Address - Fax:908-982-4344
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10266990164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse