Provider Demographics
NPI:1154163855
Name:OBUAMAH, BENEDICTA AKWELEY (OD)
Entity type:Individual
Prefix:DR
First Name:BENEDICTA
Middle Name:AKWELEY
Last Name:OBUAMAH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:32 FOREST DR APT G
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-2154
Mailing Address - Country:US
Mailing Address - Phone:845-729-1318
Mailing Address - Fax:
Practice Address - Street 1:137 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1623
Practice Address - Country:US
Practice Address - Phone:201-488-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011043152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist