Healthcare Provider Details

I. General information

NPI: 1174887244
Provider Name (Legal Business Name): CYRIL CHUKWUDI OKOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 07/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 BUCHANAN ST NW
WASHINGTON DC
20011-7116
US

IV. Provider business mailing address

818 BUCHANAN ST NW
WASHINGTON DC
20011-7116
US

V. Phone/Fax

Practice location:
  • Phone: 202-560-3298
  • Fax:
Mailing address:
  • Phone: 202-560-3298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2426525
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: