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General NPI Number Information
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NPI Number | 1881303758
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Entity Type | Individual
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Provider Name | VANESSA AMOAH OTI- AKENTEN
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 600 N 12TH ST STE 100
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City | LEMOYNE
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State | PA
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Zip | 17043-1218
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Country | US
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Telephone | 717-216-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 3932 STRATFORD RD
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City | DREXEL HILL
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State | PA
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Zip | 19026-2723
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Country | US
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Telephone | 201-289-7833
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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 | MA063304
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License Number State | PA
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