Healthcare Provider Details

I. General information

NPI: 1710463336
Provider Name (Legal Business Name): JOHN N OKKEN H.A.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N WOOD AVE
LINDEN NJ
07036-4200
US

IV. Provider business mailing address

225 N WOOD AVE
LINDEN NJ
07036-4200
US

V. Phone/Fax

Practice location:
  • Phone: 908-583-5284
  • Fax: 908-583-6297
Mailing address:
  • Phone: 908-583-5284
  • Fax: 908-583-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00038600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: