Basic Information
Provider Information
NPI: 1336793140
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSEI-MENSAH
FirstName: STEPHEN
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 N CENTRAL EXPY UNIT 2586
Address2:  
City: MCKINNEY
State: TX
PostalCode: 750700139
CountryCode: US
TelephoneNumber: 9722398176
FaxNumber:  
Practice Location
Address1: 1653 LITITZ PIKE # 1067
Address2:  
City: LANCASTER
State: PA
PostalCode: 176016507
CountryCode: US
TelephoneNumber: 7172603736
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/30/2019
LastUpdateDate: 07/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZE0600X  Y Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic

No ID Information.


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