Provider Demographics
NPI:1013749969
Name:OWUSU, ALEXANDRA ABOAGYE
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:ABOAGYE
Last Name:OWUSU
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 1:2 DARWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1202
Mailing Address - Country:US
Mailing Address - Phone:914-359-1931
Mailing Address - Fax:
Practice Address - Street 1:2 DARWOOD PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1202
Practice Address - Country:US
Practice Address - Phone:914-359-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY897962-01163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical