Provider Demographics
NPI:1336564822
Name:AMPONSAH, ABIGAIL TUTUAA (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:TUTUAA
Last Name:AMPONSAH
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 1:1591 FULTON AVE
Mailing Address - Street 2:APT 5C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8234
Mailing Address - Country:US
Mailing Address - Phone:347-854-6270
Mailing Address - Fax:
Practice Address - Street 1:1591 FULTON AVE
Practice Address - Street 2:APT 5C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8234
Practice Address - Country:US
Practice Address - Phone:347-854-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677241163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse