1275237752 NPI number — GIFTY MARFOWAA AKLASU MD

Table of content: GIFTY MARFOWAA AKLASU MD (NPI 1275237752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275237752 NPI number — GIFTY MARFOWAA AKLASU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AKLASU
Provider First Name:
GIFTY
Provider Middle Name:
MARFOWAA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARFOWAA
Provider Other First Name:
GIFTY
Provider Other Middle Name:
DONKOR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275237752
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
231 ALBERT SABIN WAY, ML 0528
Provider Second Line Business Mailing Address:
ROOM 6413
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-558-5391
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 GOODMAN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-558-5391
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2023

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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