Provider Demographics
NPI:1689838898
Name:NYANTAKYI, JANET GIFTY
Entity type:Individual
Prefix:MISS
First Name:JANET
Middle Name:GIFTY
Last Name:NYANTAKYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-5512
Mailing Address - Country:US
Mailing Address - Phone:631-434-1636
Mailing Address - Fax:631-434-1636
Practice Address - Street 1:67 4TH ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-5512
Practice Address - Country:US
Practice Address - Phone:631-434-1636
Practice Address - Fax:631-434-1636
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289375-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse