Provider Demographics
NPI:1336859859
Name:ANKRAH, CYNTHIA (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:ANKRAH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 SIOUX RD
Mailing Address - Street 2:
Mailing Address - City:N BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1613
Mailing Address - Country:US
Mailing Address - Phone:332-265-8204
Mailing Address - Fax:
Practice Address - Street 1:745 64TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4745
Practice Address - Country:US
Practice Address - Phone:718-765-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14840800363LP0808X
NYF404329-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty