Provider Demographics
NPI:1134886542
Name:SARPONG, NINNA (RN)
Entity type:Individual
Prefix:
First Name:NINNA
Middle Name:
Last Name:SARPONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2899 KINGSBRIDGE TER APT 2A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6017
Mailing Address - Country:US
Mailing Address - Phone:631-748-6612
Mailing Address - Fax:
Practice Address - Street 1:2899 KINGSBRIDGE TER APT 2A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-6017
Practice Address - Country:US
Practice Address - Phone:631-748-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY804575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse