Healthcare Provider Details

I. General information

NPI: 1710279211
Provider Name (Legal Business Name): RITA N OKAFOR LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RITA N OKAFOR LPN

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ARBUTUS ST
DORCHESTER CENTER MA
02124-3103
US

IV. Provider business mailing address

7 ARBUTUS ST
DORCHESTER CENTER MA
02124-3103
US

V. Phone/Fax

Practice location:
  • Phone: 857-205-2526
  • Fax: 627-288-2007
Mailing address:
  • Phone: 857-205-2526
  • Fax: 627-288-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLN65436
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: