Healthcare Provider Details

I. General information

NPI: 1225698970
Provider Name (Legal Business Name): JOSEPH EFOSA NOSA UWAZOTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2019
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 5TH AVE
YORK PA
17403-2632
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-8051
  • Fax:
Mailing address:
  • Phone: 717-851-2521
  • Fax: 717-260-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD478412
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: