Provider Demographics
NPI:1154164432
Name:NKRUMAH, FOSTER SOLOMON
Entity type:Individual
Prefix:
First Name:FOSTER
Middle Name:SOLOMON
Last Name:NKRUMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 MAY ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-4340
Mailing Address - Country:US
Mailing Address - Phone:774-329-7403
Mailing Address - Fax:
Practice Address - Street 1:216 W BOYLSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1788
Practice Address - Country:US
Practice Address - Phone:508-213-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty