Provider Demographics
NPI:1689318669
Name:OKLETEY, DORIS
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:OKLETEY
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 1:3017 WINDISH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-4526
Mailing Address - Country:US
Mailing Address - Phone:301-633-7651
Mailing Address - Fax:
Practice Address - Street 1:3017 WINDISH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-4526
Practice Address - Country:US
Practice Address - Phone:301-633-7651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program