Basic Information
| Provider Information | |||||||||
| NPI: | 1295468643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMOAKO | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | OFORI-ATTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 EAGLE LN | ||||||||
| Address2: | |||||||||
| City: | MECHANICVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121183533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4133427598 | ||||||||
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| Practice Location | |||||||||
| Address1: | 60 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122083103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184262801 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2022 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 714106 | NY | Y | Nursing Service Providers | Registered Nurse |
No ID Information.