Provider Demographics
NPI:1225093180
Name:ANYOKU, OBIORA OLISAELOKA (MD)
Entity Type:Individual
Prefix:
First Name:OBIORA
Middle Name:OLISAELOKA
Last Name:ANYOKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 STEELE HILL RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568
Mailing Address - Country:US
Mailing Address - Phone:516-334-8933
Mailing Address - Fax:516-334-8931
Practice Address - Street 1:20-08 SEAGIRT BLVD
Practice Address - Street 2:ALFAMED PHYSICIAN PC
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691
Practice Address - Country:US
Practice Address - Phone:718-868-4553
Practice Address - Fax:718-868-4831
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01952065Medicaid
NY01952065Medicaid
03617Medicare ID - Type Unspecified