Provider Demographics
NPI:1720608607
Name:ASAMOA-AFRIYIE, COLLINS K (PHD, MPH, MCHES)
Entity Type:Individual
Prefix:DR
First Name:COLLINS
Middle Name:K
Last Name:ASAMOA-AFRIYIE
Suffix:
Gender:M
Credentials:PHD, MPH, MCHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 N 5TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-2911
Mailing Address - Country:US
Mailing Address - Phone:862-235-3165
Mailing Address - Fax:
Practice Address - Street 1:35 N 5TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2911
Practice Address - Country:US
Practice Address - Phone:862-235-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
31176174N00000X, 246ZG1000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No246ZG1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGeneticist, Medical (PhD)