Individual
MR. MICHAEL OTIBU ABOAGYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
33 INDEPENDENCE WAY, MILLER PLACE, NY 11764-2337
(646) 420-4475
Mailing address
77 WAVERLY AVE, APARTMENT 118, PATCHOGUE, NY 11772-2188
(646) 420-4475
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
649259
NY
363L00000X
Nurse Practitioner
Primary
345351
NY
Other
Enumeration date
08/09/2011
Last updated
09/30/2020
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