Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MA48939 | NJ |
NPI | 1134346901 |
---|---|
Provider Name | Dr. Emmanuel Nyaba Yamusah |
First Address | Paterson, NJ 07514-1925 |
Second Address | Paterson, NJ 07514-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |