Healthcare Provider Details

I. General information

NPI: 1669363586
Provider Name (Legal Business Name): OLUCHI FRANCA OKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 ATLANTIC AVE
BROOKLYN NY
11213-1122
US

IV. Provider business mailing address

29 N KING ST
MALVERNE NY
11565-1001
US

V. Phone/Fax

Practice location:
  • Phone: 718-613-4000
  • Fax:
Mailing address:
  • Phone: 646-812-7975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF312061-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: