Provider Demographics
NPI:1679989891
Name:BOKO, AUBREY MAY
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:MAY
Last Name:BOKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBREY MAY
Other - Middle Name:BABAYEN ON
Other - Last Name:BOKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8817 62ND DR
Mailing Address - Street 2:FL 2
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2822
Mailing Address - Country:US
Mailing Address - Phone:646-468-4143
Mailing Address - Fax:
Practice Address - Street 1:8817 62ND DR
Practice Address - Street 2:FL 2
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2822
Practice Address - Country:US
Practice Address - Phone:646-468-4143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621403163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical