Provider Demographics
NPI:1447442587
Name:ANTHONY K FREMPONG-BOADU
Entity type:Organization
Organization Name:ANTHONY K FREMPONG-BOADU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:K
Authorized Official - Last Name:FREMPONG-BOADU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-263-6514
Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:DEPARTMENT OF NEUROSURGERY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-6514
Mailing Address - Fax:212-263-8225
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 5C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-6514
Practice Address - Fax:212-263-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199352207T00000X
FLME79239207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02039403Medicaid
NYBF6162729OtherDEA
NYH08847Medicare UPIN
NYBF6162729OtherDEA