Provider Demographics
NPI:1134955628
Name:OPATA, GODSON F
Entity type:Individual
Prefix:
First Name:GODSON
Middle Name:F
Last Name:OPATA
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 1:2400 HUNTER AVE APT 15D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5613
Mailing Address - Country:US
Mailing Address - Phone:914-426-4220
Mailing Address - Fax:
Practice Address - Street 1:2400 HUNTER AVE APT 15D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-5613
Practice Address - Country:US
Practice Address - Phone:914-426-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist