Kwame Panin Boachie

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P11540 Issued in NY

Practice address

6136 170TH St Apt M4
Fresh Meadows, NY 11365-1957

Phone

(347) 709-3133

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1841953460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-136 MLK JR BLVD # B1312",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071045348",
            "telephone_number": "862-291-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 170TH ST APT M4",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651957",
            "telephone_number": "347-709-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOACHIE",
        "first_name": "KWAME",
        "middle_name": "PANIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P11540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.