Healthcare Provider Details

I. General information

NPI: 1841620663
Provider Name (Legal Business Name): TOKUNBOH M. OBASI M.S.; CNS; RH (AHG)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: OLA OBASI

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5824 FORBES AVE. SUITE 2A
PITTSBURGH PA
15217
US

IV. Provider business mailing address

5824 FORBES AVE. SUITE 2A
PITTSBURGH PA
15217
US

V. Phone/Fax

Practice location:
  • Phone: 412-685-4016
  • Fax:
Mailing address:
  • Phone: 412-685-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberCNS16397
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberCNS16397
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: