Provider Demographics
NPI:1215010988
Name:BRONX STATE HOSPITAL
Entity Type:Organization
Organization Name:BRONX STATE HOSPITAL
Other - Org Name:BROOKLYN CHILDREN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHILD & ADOLESCENT PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:TOCHUKWU
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-862-5409
Mailing Address - Street 1:341 S 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4113
Mailing Address - Country:US
Mailing Address - Phone:718-862-5409
Mailing Address - Fax:
Practice Address - Street 1:1500 WATERS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2723
Practice Address - Country:US
Practice Address - Phone:718-862-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP46503283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital