Provider Demographics
NPI:1609823434
Name:OKE, BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:OKE
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:PO BOX 2000
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2000
Mailing Address - Country:US
Mailing Address - Phone:518-828-8363
Mailing Address - Fax:518-697-3388
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-3327
Practice Address - Fax:518-697-8158
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001987-5207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
713933OtherMVP
84S123OtherBC/BS
240746OtherWELLCARE
051101000040OtherFIDELIS
10078795OtherCDPHP
P00156463OtherRAILROAD MEDICARE
000407420001OtherBSNENY
NY02563784Medicaid
85311OtherGHI HMO
2390544OtherUNITEDHEALTH CARE
2589663OtherGHI PPO
P00156463OtherRAILROAD MEDICARE
051101000040OtherFIDELIS
2589663OtherGHI PPO
NYW23281Medicare ID - Type Unspecified
NY02563784Medicaid