Provider Demographics
NPI:1982347712
Name:OKONKWO, EMEKA ALBERT
Entity Type:Individual
Prefix:
First Name:EMEKA
Middle Name:ALBERT
Last Name:OKONKWO
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 1:218 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3605
Mailing Address - Country:US
Mailing Address - Phone:240-217-1710
Mailing Address - Fax:
Practice Address - Street 1:772 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3172
Practice Address - Country:US
Practice Address - Phone:347-843-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse