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General NPI Number Information
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NPI Number | 1174871602
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Entity Type | Individual
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Provider Name | FAITH CYNTHIA OKOBI SERVICE COORDINATOR
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 21426 41ST AVE STE BAYSIDE SUITE 130
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City | BAYSIDE
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State | NY
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Zip | 11361-2159
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Country | US
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Telephone | 718-631-1110
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Fax | 718-631-1314
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Provider Business Mailing Address
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Address Line | 16809 110TH AVE
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City | JAMAICA
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State | NY
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Zip | 11433-3463
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Country | US
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Telephone | 917-627-6009
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Fax | 718-523-0013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NY
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