Provider Demographics
NPI:1699776971
Name:AMANQUAH, LENA (DO)
Entity type:Individual
Prefix:DR
First Name:LENA
Middle Name:
Last Name:AMANQUAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E 116TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1451
Mailing Address - Country:US
Mailing Address - Phone:212-203-4444
Mailing Address - Fax:212-203-4444
Practice Address - Street 1:208 E 116TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-203-4444
Practice Address - Fax:212-203-4444
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223172208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY223172Medicaid