Provider Demographics
NPI:1346484219
Name:OKORO, NDUBUISI DON, O (MSC)
Entity Type:Individual
Prefix:MR
First Name:NDUBUISI
Middle Name:DON, O
Last Name:OKORO
Suffix:
Gender:M
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 RHOADS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2923
Mailing Address - Country:US
Mailing Address - Phone:267-767-8900
Mailing Address - Fax:
Practice Address - Street 1:7423 RHOADS ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2923
Practice Address - Country:US
Practice Address - Phone:267-767-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst