Provider Demographics
NPI:1659022564
Name:OFOSU-DONKOH, KOBINA
Entity Type:Individual
Prefix:
First Name:KOBINA
Middle Name:
Last Name:OFOSU-DONKOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 PASSMORE ST STE 910
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-5537
Mailing Address - Country:US
Mailing Address - Phone:267-521-6825
Mailing Address - Fax:
Practice Address - Street 1:1332 PASSMORE ST STE 910
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5537
Practice Address - Country:US
Practice Address - Phone:267-521-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN312906164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse