Healthcare Provider Details

I. General information

NPI: 1659167187
Provider Name (Legal Business Name): SELINA OKYERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 ASCH LOOP APT 26E
BRONX NY
10475-4072
US

IV. Provider business mailing address

140 ASCH LOOP APT 26E
BRONX NY
10475-4072
US

V. Phone/Fax

Practice location:
  • Phone: 347-547-9417
  • Fax:
Mailing address:
  • Phone: 347-547-9417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number879934
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number879934
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number879934
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number879934
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number879934
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: