Healthcare Provider Details

I. General information

NPI: 1831472109
Provider Name (Legal Business Name): CHRISTOPHER OSAYANDE AGHEDO PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 BALTIMORE PIKE STE 250
SPRINGFIELD PA
19064-3974
US

IV. Provider business mailing address

1489 BALTIMORE PIKE STE 250
SPRINGFIELD PA
19064-3974
US

V. Phone/Fax

Practice location:
  • Phone: 610-544-2110
  • Fax: 610-604-9510
Mailing address:
  • Phone: 610-544-2110
  • Fax: 610-604-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN612681
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP024835
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: