| Doctor Name: | MR. OBIOMA GODSWILL ATUFUNWA |
| NPI Number: | 1003209396 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | MA057503 |
| Business Practice Address: | 501 Bath Rd Bristol, PA - 190073101 |
| Business Phone Number: | 2157859200 |
| Business Fax Number: | |
| Mailing Address: | 66 W Gilbert St Ste 100, TINTON FALLS |
| State: | NJ |
| Postal Code: | 077014948 |
| Phone Number: | 7322120060 |
| Fax Number: | 7322120061 |
| NPI Enumeration Date: | 03/10/2015 |
| NPI Last Update Date: | 03/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA057503 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |