Provider Demographics
NPI:1427168210
Name:ACHAMPONG, AKWASI AFRIYIE (DO)
Entity type:Individual
Prefix:MR
First Name:AKWASI
Middle Name:AFRIYIE
Last Name:ACHAMPONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 030682
Mailing Address - Street 2:ELMONT MEDICAL PC
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003
Mailing Address - Country:US
Mailing Address - Phone:516-354-5600
Mailing Address - Fax:516-354-1480
Practice Address - Street 1:135 ROCKMART AVENUE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003
Practice Address - Country:US
Practice Address - Phone:516-354-5600
Practice Address - Fax:516-354-1480
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02061609Medicaid
H13118Medicare UPIN
NY02061609Medicaid
NY05952GMedicare PIN