Provider Demographics
NPI:1255906152
Name:OYOGHO, DORIS (NP)
Entity type:Individual
Prefix:MS
First Name:DORIS
Middle Name:
Last Name:OYOGHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:OGHENOVO
Other - Last Name:OKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:100 CARVER LOOP APT 15B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-2932
Mailing Address - Country:US
Mailing Address - Phone:646-319-4900
Mailing Address - Fax:347-843-6877
Practice Address - Street 1:100 CARVER LOOP APT 15B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-2932
Practice Address - Country:US
Practice Address - Phone:646-319-4900
Practice Address - Fax:347-843-6877
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344315-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily