Provider Demographics
NPI:1053160838
Name:OSEI-BONSU, NANA JR
Entity type:Individual
Prefix:
First Name:NANA
Middle Name:
Last Name:OSEI-BONSU
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KONKEL AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-3543
Mailing Address - Country:US
Mailing Address - Phone:774-420-5176
Mailing Address - Fax:
Practice Address - Street 1:14 KONKEL AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-3543
Practice Address - Country:US
Practice Address - Phone:774-420-5176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician