Provider Demographics
NPI:1578318416
Name:OBAJI, HAYA
Entity Type:Individual
Prefix:
First Name:HAYA
Middle Name:
Last Name:OBAJI
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 1:10 LEWIS LNDG
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3864
Mailing Address - Country:US
Mailing Address - Phone:251-518-5294
Mailing Address - Fax:
Practice Address - Street 1:120 LOCUST AVE EXT
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:PA
Practice Address - Zip Code:15349-1355
Practice Address - Country:US
Practice Address - Phone:724-324-9001
Practice Address - Fax:724-324-9005
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program