Provider Demographics
NPI:1730980582
Name:GHAFFAAR, OZELL
Entity type:Individual
Prefix:
First Name:OZELL
Middle Name:
Last Name:GHAFFAAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MACDADE BLVD STE 2-253
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1611
Mailing Address - Country:US
Mailing Address - Phone:610-663-7108
Mailing Address - Fax:
Practice Address - Street 1:1300 MACDADE BLVD STE 2-253
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-1611
Practice Address - Country:US
Practice Address - Phone:610-663-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker