Provider Demographics
NPI:1649210519
Name:OKEKE, EMEKA E (MD)
Entity Type:Individual
Prefix:
First Name:EMEKA
Middle Name:E
Last Name:OKEKE
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 1:19621 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2124
Mailing Address - Country:US
Mailing Address - Phone:718-465-4605
Mailing Address - Fax:718-217-6286
Practice Address - Street 1:19621 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2124
Practice Address - Country:US
Practice Address - Phone:718-465-4605
Practice Address - Fax:718-217-6286
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168703207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01485574Medicaid
NY02349AMedicare ID - Type Unspecified
NY01485574Medicaid