Provider Demographics
NPI:1710691407
Name:OKPARA, BENNETH N
Entity Type:Individual
Prefix:
First Name:BENNETH
Middle Name:N
Last Name:OKPARA
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 1:305 MARLBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT EPHRAIM
Mailing Address - State:NJ
Mailing Address - Zip Code:08059-1922
Mailing Address - Country:US
Mailing Address - Phone:856-366-6577
Mailing Address - Fax:
Practice Address - Street 1:305 MARLBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT EPHRAIM
Practice Address - State:NJ
Practice Address - Zip Code:08059-1922
Practice Address - Country:US
Practice Address - Phone:856-366-6577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician