Healthcare Provider Details

I. General information

NPI: 1871068684
Provider Name (Legal Business Name): LORNA L OKLETEY PA-C, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 CITY AVE STE 528
PHILADELPHIA PA
19131-1635
US

IV. Provider business mailing address

418 ELM AVE
CROYDON PA
19021-6908
US

V. Phone/Fax

Practice location:
  • Phone: 949-366-1053
  • Fax:
Mailing address:
  • Phone: 240-481-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA060198
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA060198
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: