Individual
SAMUEL BOATENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
999 DALTON AVE, PITTSFIELD, MA 01201-2903
(413) 448-6231
Mailing address
515 FAIRMOUNT AVE, TOWSON, MD 21286-5466
(301) 758-2350
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F0415163
MD
363LF0000X
Family Nurse Practitioner
Primary
RN2316205
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790162527
—
MA
Enumeration date
04/30/2015
Last updated
02/09/2019
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