Provider Demographics
NPI:1124256482
Name:OFOSU, AKOSUA
Entity type:Individual
Prefix:
First Name:AKOSUA
Middle Name:
Last Name:OFOSU
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 1:1209 SASSAFRAS CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-3868
Mailing Address - Country:US
Mailing Address - Phone:856-740-0995
Mailing Address - Fax:
Practice Address - Street 1:1209 SASSAFRAS CT
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-3868
Practice Address - Country:US
Practice Address - Phone:856-740-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ234700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse