Basic Information
Provider Information | |||||||||
NPI: | 1609212554 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AKUFFO | ||||||||
FirstName: | FRIEDA | ||||||||
MiddleName: | KWAATI | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | AKUFFO-OSEI | ||||||||
OtherFirstName: | FRIEDA | ||||||||
OtherMiddleName: | KWAATI | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 2570 ROUTE 9W STE 10 | ||||||||
Address2: |   | ||||||||
City: | CORNWALL | ||||||||
State: | NY | ||||||||
PostalCode: | 125181370 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8452203100 | ||||||||
FaxNumber: | 8455342940 | ||||||||
Practice Location | |||||||||
Address1: | 147 LAKE ST | ||||||||
Address2: |   | ||||||||
City: | NEWBURGH | ||||||||
State: | NY | ||||||||
PostalCode: | 12550 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8455638000 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/20/2013 | ||||||||
LastUpdateDate: | 07/30/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 287092 | NY | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
No ID Information.