MEDICARE: ANTHONY OKEKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	40QA00590500	OTHER	NJ	LICENSE

General Provider Information

NPI Number	:	1497865372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY OKEKE

Provider Business Mailing Address
First Line	:	40 UNION AVE
Second Line	:	SUITE 304
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3277
Country	:	US
Telephone Number	:	973-416-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 UNION AVE
Second Line	:	SUITE 304
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3277
Country	:	US
Telephone Number	:	973-416-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/09/2011

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Directions to “ ANTHONY OKEKE ” Practice Location

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