Healthcare Provider Details

I. General information

NPI: 1427483031
Provider Name (Legal Business Name): MARIA C OKWOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2013
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1474 TANYARD ROAD SUITE C100
SEWELL NJ
08080
US

IV. Provider business mailing address

2019 SUTTON AVE
NORTHFIELD NJ
08225-1038
US

V. Phone/Fax

Practice location:
  • Phone: 856-932-7476
  • Fax: 856-566-6320
Mailing address:
  • Phone: 609-977-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00815100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: