Provider Demographics
NPI:1891298055
Name:OKAFOR, GOLDSTEIN
Entity Type:Individual
Prefix:
First Name:GOLDSTEIN
Middle Name:
Last Name:OKAFOR
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 1:770 N ELDRIDGE PKWY APT 125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4493
Mailing Address - Country:US
Mailing Address - Phone:972-786-2992
Mailing Address - Fax:
Practice Address - Street 1:620 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1810
Practice Address - Country:US
Practice Address - Phone:313-278-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2472B0301X
TX121749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No2472B0301XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherBiomedical Engineering