Provider Demographics
NPI:1184602492
Name:OSEI, RAPHAEL KWABENA (MD)
Entity type:Individual
Prefix:
First Name:RAPHAEL
Middle Name:KWABENA
Last Name:OSEI
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 1:947 CRAMER CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1216
Mailing Address - Country:US
Mailing Address - Phone:516-546-2204
Mailing Address - Fax:516-546-0315
Practice Address - Street 1:947 CRAMER CT
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1216
Practice Address - Country:US
Practice Address - Phone:516-546-2204
Practice Address - Fax:516-546-0315
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY139335208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00659361Medicaid