Provider Demographics
NPI:1801228473
Name:OFORI-ATTA, AFIA
Entity type:Individual
Prefix:
First Name:AFIA
Middle Name:
Last Name:OFORI-ATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:OFORI-ATTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:670 DOWNEY GREEN ST
Mailing Address - Street 2:APT.334
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2283
Mailing Address - Country:US
Mailing Address - Phone:703-944-3444
Mailing Address - Fax:
Practice Address - Street 1:3326 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3807
Practice Address - Country:US
Practice Address - Phone:757-826-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist