Provider Demographics
NPI:1861638579
Name:OKWU-UWA, STANLEY AZWENU
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:AZWENU
Last Name:OKWU-UWA
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 1:1750 SEDGWICK AVE
Mailing Address - Street 2:2-N
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-6638
Mailing Address - Country:US
Mailing Address - Phone:646-667-6363
Mailing Address - Fax:
Practice Address - Street 1:1750 SEDGWICK AVE
Practice Address - Street 2:2-N
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-6638
Practice Address - Country:US
Practice Address - Phone:646-667-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287509-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse