1932732138 NPI number — CYNTHIA AYOKI OKELLO CRNA, DNP

Table of content: CYNTHIA AYOKI OKELLO CRNA, DNP (NPI 1932732138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932732138 NPI number — CYNTHIA AYOKI OKELLO CRNA, DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKELLO
Provider First Name:
CYNTHIA
Provider Middle Name:
AYOKI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA, DNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OKECH
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
AYOKI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA, DNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932732138
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9000 DEE LN APT 9214
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MALVERN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19355-8845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-309-9248
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 W LANCASTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAOLI
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19301-1763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-565-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC0200X , with the licence number:  26NR19338800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC0200X , with the licence number: RN691633 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 131856 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)