Provider Demographics
NPI:1952318057
Name:BOACHIE-ADJEI, OHENEBA (MD)
Entity Type:Individual
Prefix:
First Name:OHENEBA
Middle Name:
Last Name:BOACHIE-ADJEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-606-1948
Mailing Address - Fax:212-794-2562
Practice Address - Street 1:523 E 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-606-1948
Practice Address - Fax:212-794-2562
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1467731207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A95536Medicare UPIN
31J571Medicare ID - Type Unspecified