Provider Demographics
NPI:1093020679
Name:OKOJIE, CLEMENTINA ONOHOMEN
Entity Type:Individual
Prefix:
First Name:CLEMENTINA
Middle Name:ONOHOMEN
Last Name:OKOJIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1205
Mailing Address - Country:US
Mailing Address - Phone:973-960-3026
Mailing Address - Fax:732-969-5565
Practice Address - Street 1:51 BEACON ST
Practice Address - Street 2:
Practice Address - City:PORT READING
Practice Address - State:NJ
Practice Address - Zip Code:07064-1205
Practice Address - Country:US
Practice Address - Phone:973-960-3026
Practice Address - Fax:732-969-5565
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301106-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse