Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 130473-1 | NY |
NPI | 1831190354 |
---|---|
Provider Name | Kwame Anyane-Yeboa |
First Address | Philadelphia, PA 19195-2243 |
Second Address | New York, NY 10019-1147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00506827 | (05) | NY |
B14215 | (02) | NY |