Provider Demographics
NPI:1265921662
Name:DEKYI, FREMLIN A JR (MD)
Entity type:Individual
Prefix:DR
First Name:FREMLIN
Middle Name:A
Last Name:DEKYI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AKWASI
Other - Middle Name:
Other - Last Name:DEKYI
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:AKWASI DEKYI
Mailing Address - Street 1:9341 SPRINGFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1863
Mailing Address - Country:US
Mailing Address - Phone:315-415-3546
Mailing Address - Fax:845-622-9111
Practice Address - Street 1:9341 SPRINGFIELD BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-1863
Practice Address - Country:US
Practice Address - Phone:917-428-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306876208D00000X, 207Q00000X
NY261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care