Provider Demographics
NPI:1790082907
Name:EKOKOBE, CYNTHIA P (LPN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:P
Last Name:EKOKOBE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1437 SHAKESPEARE AVE
Mailing Address - Street 2:5A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-1865
Mailing Address - Country:US
Mailing Address - Phone:718-229-3246
Mailing Address - Fax:
Practice Address - Street 1:1499 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2128
Practice Address - Country:US
Practice Address - Phone:914-235-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242933164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse