Provider Demographics
NPI:1114523867
Name:OKAH, STELLA
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:OKAH
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 1:625 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2008
Mailing Address - Country:US
Mailing Address - Phone:908-282-5770
Mailing Address - Fax:
Practice Address - Street 1:765 ROUTE 70 E BLDG A
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-983-3900
Practice Address - Fax:856-797-4785
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01087700363LP0808X, 363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool