Provider Demographics
NPI:1528373065
Name:UNIVERSAL FAMILY MEDICAL CENTER PA
Entity Type:Organization
Organization Name:UNIVERSAL FAMILY MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NNACHI
Authorized Official - Middle Name:L
Authorized Official - Last Name:OKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-276-1722
Mailing Address - Street 1:601 N CONGRESS AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4640
Mailing Address - Country:US
Mailing Address - Phone:561-276-1722
Mailing Address - Fax:561-276-7919
Practice Address - Street 1:601 N CONGRESS AVE STE 408
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4640
Practice Address - Country:US
Practice Address - Phone:561-276-1722
Practice Address - Fax:561-276-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty