Provider Demographics
NPI:1356486914
Name:AWUAH, KWAME BONSU (RPA-C)
Entity type:Individual
Prefix:MR
First Name:KWAME
Middle Name:BONSU
Last Name:AWUAH
Suffix:
Gender:
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:260 53RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1717
Mailing Address - Country:US
Mailing Address - Phone:347-248-0744
Mailing Address - Fax:
Practice Address - Street 1:521 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6203
Practice Address - Country:US
Practice Address - Phone:212-695-4444
Practice Address - Fax:929-200-8895
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009643-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400012462Medicare PIN