Individual
MR. BONIFACE EMEKA OHAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
22 BIRCH DR, RANDOLPH, MA 02368-3404
(857) 719-3306
Mailing address
22 BIRCH DR, RANDOLPH, MA 02368-3404
(857) 719-3306
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN94695
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
MA
Enumeration date
03/02/2020
Last updated
03/02/2020
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