Provider Demographics
NPI:1013473255
Name:YEBOAH, FRANK KWABENA (LNHA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:KWABENA
Last Name:YEBOAH
Suffix:
Gender:M
Credentials:LNHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROSEBUD CT
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-5620
Mailing Address - Country:US
Mailing Address - Phone:518-506-1924
Mailing Address - Fax:
Practice Address - Street 1:100 NEW TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12182-1412
Practice Address - Country:US
Practice Address - Phone:518-235-1410
Practice Address - Fax:518-235-1632
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANH5488376G00000X
NJ3143376G00000X
NY05809376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator