Provider Demographics
NPI:1821332545
Name:OKWUOHA, MILTON CHIMA (RN)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:CHIMA
Last Name:OKWUOHA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 57TH AVE APT 17J
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3539
Mailing Address - Country:US
Mailing Address - Phone:917-385-8832
Mailing Address - Fax:
Practice Address - Street 1:9131 QUEENS BLVD STE 604
Practice Address - Street 2:STE 604
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5501
Practice Address - Country:US
Practice Address - Phone:718-779-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY592302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse