Provider Demographics
NPI:1003173832
Name:OKEREKE, UCHENNA REBECCA (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:UCHENNA
Middle Name:REBECCA
Last Name:OKEREKE
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WASHINGTON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4009
Mailing Address - Country:US
Mailing Address - Phone:781-762-5858
Mailing Address - Fax:
Practice Address - Street 1:95 WASHINGTON ST STE 210
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-4009
Practice Address - Country:US
Practice Address - Phone:781-762-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271034208D00000X
IAR-10699207N00000X
MA286181207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice