Provider Demographics
NPI:1649983230
Name:AMPRATWUM, PRINCE OPPONG
Entity type:Individual
Prefix:
First Name:PRINCE
Middle Name:OPPONG
Last Name:AMPRATWUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2985 BOTANICAL SQ APT 3P
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2434
Mailing Address - Country:US
Mailing Address - Phone:347-294-6509
Mailing Address - Fax:
Practice Address - Street 1:406 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5010
Practice Address - Country:US
Practice Address - Phone:718-220-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program