Healthcare Provider Details

I. General information

NPI: 1679900708
Provider Name (Legal Business Name): ORAKWAO DAVID DOWUONA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 EMPIRE AVE
FAR ROCKAWAY NY
11691-4856
US

IV. Provider business mailing address

829 EMPIRE AVE
FAR ROCKAWAY NY
11691-4856
US

V. Phone/Fax

Practice location:
  • Phone: 718-337-4800
  • Fax: 718-337-4808
Mailing address:
  • Phone: 718-337-4800
  • Fax: 718-337-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number163398
License Number StateNY

VIII. Authorized Official

Name: DR. ORAKWAO DAVID DOWUONA
Title or Position: PHYSICIAN
Credential: MD
Phone: 718-337-4800