Provider Demographics
NPI:1558654947
Name:ASIEDU, NAPHTALI (LPN)
Entity type:Individual
Prefix:MR
First Name:NAPHTALI
Middle Name:
Last Name:ASIEDU
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 FULTON AVE
Mailing Address - Street 2:APT. 5C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8234
Mailing Address - Country:US
Mailing Address - Phone:347-744-7084
Mailing Address - Fax:
Practice Address - Street 1:1591 FULTON AVE
Practice Address - Street 2:APT. 5C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8234
Practice Address - Country:US
Practice Address - Phone:347-744-7084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300848-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse