Healthcare Provider Details

I. General information

NPI: 1679273338
Provider Name (Legal Business Name): DORIS U OKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 BOSTON POST RD STE 100
GUILFORD CT
06437-4335
US

IV. Provider business mailing address

121 PROMENADE DR
HAMDEN CT
06514-2340
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-6481
  • Fax: 203-932-4051
Mailing address:
  • Phone: 203-988-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11551
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11551
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: