Provider Demographics
NPI:1184816100
Name:OKORAFOR, NNENNAYA CHIKAODINAKA (MD)
Entity Type:Individual
Prefix:DR
First Name:NNENNAYA
Middle Name:CHIKAODINAKA
Last Name:OKORAFOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SMITH ST APT A3
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2490
Mailing Address - Country:US
Mailing Address - Phone:973-374-7837
Mailing Address - Fax:
Practice Address - Street 1:295 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2000
Practice Address - Country:US
Practice Address - Phone:973-345-9745
Practice Address - Fax:973-278-9885
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08053900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0174211Medicaid