Provider Demographics
NPI:1740008812
Name:OFOSU, AMMA S
Entity type:Individual
Prefix:
First Name:AMMA
Middle Name:S
Last Name:OFOSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 MAIN ST # 102A
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3221
Mailing Address - Country:US
Mailing Address - Phone:646-387-8065
Mailing Address - Fax:
Practice Address - Street 1:213 MAIN ST STE 102A
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3221
Practice Address - Country:US
Practice Address - Phone:646-387-8065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM26NR20403400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse