Provider Demographics
NPI:1518409119
Name:SOKENU, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SOKENU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 CHIMNEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-1625
Mailing Address - Country:US
Mailing Address - Phone:585-820-7259
Mailing Address - Fax:
Practice Address - Street 1:279 CHIMNEY HILL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-1625
Practice Address - Country:US
Practice Address - Phone:585-820-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY694445-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse