Healthcare Provider Details

I. General information

NPI: 1891298055
Provider Name (Legal Business Name): GOLDSTEIN OKAFOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 GERMANTOWN PIKE
LAFAYETTE HILL PA
19444-1810
US

IV. Provider business mailing address

770 N ELDRIDGE PKWY APT 125
HOUSTON TX
77079-4493
US

V. Phone/Fax

Practice location:
  • Phone: 313-278-2327
  • Fax:
Mailing address:
  • Phone: 972-786-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2472B0301X
TaxonomyBiomedical Engineering Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number121749
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: