Provider Demographics
NPI:1851831648
Name:NWOKOCHA, OLUCHI JOY (DPT)
Entity Type:Individual
Prefix:
First Name:OLUCHI
Middle Name:JOY
Last Name:NWOKOCHA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:OLUCHI
Other - Middle Name:JOY
Other - Last Name:OGBONNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:130 GLENWOOD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2642
Mailing Address - Country:US
Mailing Address - Phone:917-589-0927
Mailing Address - Fax:
Practice Address - Street 1:130 GLENWOOD AVE APT 1
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2642
Practice Address - Country:US
Practice Address - Phone:917-589-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist