Healthcare Provider Details

I. General information

NPI: 1558603506
Provider Name (Legal Business Name): MICHAEL A OKOYE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2013
Last Update Date: 07/21/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1614 MICHAEL DR
PITTSBURGH PA
15227-3959
US

IV. Provider business mailing address

1614 MICHAEL DR
PITTSBURGH PA
15227-3959
US

V. Phone/Fax

Practice location:
  • Phone: 202-365-5466
  • Fax: 866-546-4305
Mailing address:
  • Phone: 202-365-5466
  • Fax: 866-546-4305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP012899
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRNTEMP17124
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: