Provider Demographics
NPI:1770864704
Name:OKORONKWO, NNEOMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NNEOMA
Middle Name:
Last Name:OKORONKWO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22-02 BROADWAY # 301
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3016
Mailing Address - Country:US
Mailing Address - Phone:201-414-5732
Mailing Address - Fax:
Practice Address - Street 1:22-02 BROADWAY # 301
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3016
Practice Address - Country:US
Practice Address - Phone:201-414-5732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-03
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09752000207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine