Provider Demographics
NPI:1255968178
Name:OKUNBOR, PRECIOUS (MD)
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:OKUNBOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NEW HAVEN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3398
Mailing Address - Country:US
Mailing Address - Phone:203-877-5634
Mailing Address - Fax:
Practice Address - Street 1:1 NEW HAVEN AVE STE 101
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3398
Practice Address - Country:US
Practice Address - Phone:203-877-5634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT79456207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology