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General NPI Number Information
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NPI Number | 1356450472
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Entity Type | Individual
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Provider Name | GUILENE OJIKUTU PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 BLACKHORSE HILL RD
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City | COATESVILLE
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State | PA
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Zip | 19320-2040
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Country | US
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Telephone | 610-384-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 1071 PENN CIR APT. G-414
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1165
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Country | US
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Telephone | 401-374-7249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA052268
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License Number State | PA
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