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Individual

IRENE BOAKYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3424 KOSSUTH AVE, BRONX, NY 10467-2410
(718) 519-5000
Mailing address
301 W 111TH ST APT 3A, NEW YORK, NY 10026-4072
(347) 569-7239

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029293
PHYSICIAN ASSISTANT LICENSE
05
TX52501U
NY
Enumeration date
12/12/2022
Last updated
12/12/2022
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