Healthcare Provider Details

I. General information

NPI: 1659627727
Provider Name (Legal Business Name): JENNIFER FATIMATU OKOYE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER FATIMATU OKOYE RN

II. Dates (important events)

Enumeration Date: 07/26/2012
Last Update Date: 07/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

772 E 233RD ST
BRONX NY
10466-3200
US

IV. Provider business mailing address

772 E 233RD ST
BRONX NY
10466-3200
US

V. Phone/Fax

Practice location:
  • Phone: 347-843-0444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number656215-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: