Provider Demographics
NPI:1235177437
Name:OKEZIE, CHUKUEKE TOBENNA (MD)
Entity Type:Individual
Prefix:
First Name:CHUKUEKE
Middle Name:TOBENNA
Last Name:OKEZIE
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 1:351 EVELYN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2901
Mailing Address - Country:US
Mailing Address - Phone:201-265-3111
Mailing Address - Fax:201-265-3117
Practice Address - Street 1:351 EVELYN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2901
Practice Address - Country:US
Practice Address - Phone:201-265-3111
Practice Address - Fax:201-265-3117
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67932207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7720106Medicaid
G83528Medicare UPIN
NJ7720106Medicaid
6266120001Medicare NSC