Healthcare Provider Details

I. General information

NPI: 1912974437
Provider Name (Legal Business Name): CHIKA OKPALANMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 E GUN HILL RD SUITE B
BRONX NY
10469-3037
US

IV. Provider business mailing address

1452 E GUN HILL RD SUITE B
BRONX NY
10469-3037
US

V. Phone/Fax

Practice location:
  • Phone: 718-653-3711
  • Fax: 718-652-8492
Mailing address:
  • Phone: 718-653-3711
  • Fax: 718-652-8492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number187281
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: