Healthcare Provider Details

I. General information

NPI: 1457093049
Provider Name (Legal Business Name): JAMES OKORIE OKEREKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GRAND CONCOURSE
BRONX NY
10457-7697
US

IV. Provider business mailing address

24 HOWARD ST
BLOOMFIELD NJ
07003-3912
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-1449
  • Fax: 718-518-5124
Mailing address:
  • Phone: 332-209-9323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA12664800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: