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General NPI Number Information
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NPI Number | 1457459042
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Entity Type | Organization
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Legal Business Name | NASSAU WEST OB/GYN P.C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 229 BALDWIN RD
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City | HEMPSTEAD
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State | NY
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Zip | 11550-6931
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Country | US
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Telephone | 516-481-2120
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Fax | 516-481-5030
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Provider Business Mailing Address
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Address Line | 466 MAPLE AVE P.O.BOX 10319
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City | WESTBURY
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State | NY
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Zip | 11590-3247
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Country | US
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Telephone | 516-481-2120
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Fax | 516-481-5030
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. OKORO C UKPABI
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Credential | M.D.
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Telephone | 516-481-2120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 147641
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License Number State | NY
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