Healthcare Provider Details

I. General information

NPI: 1083857882
Provider Name (Legal Business Name): ROBERT UCHE OKOLIE DNP, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2632 E 14TH ST FL 3
BROOKLYN NY
11235-3916
US

IV. Provider business mailing address

2632 E 14TH ST FL 3
BROOKLYN NY
11235-3916
US

V. Phone/Fax

Practice location:
  • Phone: 718-696-0660
  • Fax:
Mailing address:
  • Phone: 718-696-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335830
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: