Provider Demographics
NPI:1396224655
Name:DAPAAH, OPHELIA
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:
Last Name:DAPAAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 UPPER SKY WAY UNIT 403
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5642
Mailing Address - Country:US
Mailing Address - Phone:646-712-1176
Mailing Address - Fax:
Practice Address - Street 1:730 N ASHBURTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-4703
Practice Address - Country:US
Practice Address - Phone:410-233-0684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342243363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily