Healthcare Provider Details

I. General information

NPI: 1174733349
Provider Name (Legal Business Name): GODGIVE OKOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 BROADWAY
NEW YORK NY
10034-1159
US

IV. Provider business mailing address

PO BOX 144
SCARSDALE NY
10583-0144
US

V. Phone/Fax

Practice location:
  • Phone: 212-932-4142
  • Fax: 212-932-5429
Mailing address:
  • Phone: 914-843-2968
  • Fax: 212-932-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000261-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: