Provider Demographics
NPI:1336565522
Name:OPOKU, AMA (LPN)
Entity Type:Individual
Prefix:
First Name:AMA
Middle Name:
Last Name:OPOKU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 TOPPING AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7161
Mailing Address - Country:US
Mailing Address - Phone:646-410-7679
Mailing Address - Fax:
Practice Address - Street 1:1660 TOPPING AVE APT 1J
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7161
Practice Address - Country:US
Practice Address - Phone:646-410-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317830164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse