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NPI 1558610667

NPI 1558610667 : CAROLINE UCHE OKONKWO NP-C : EAST ORANGE, NJ

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General NPI Number Information
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    NPI Number           |    1558610667
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    Entity Type          |    Individual 
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    Provider Name        |    CAROLINE UCHE OKONKWO NP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/05/2012
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    Last Update Date     |    09/05/2012
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Provider Practice Location Address
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    Address Line         |    444 WILLIAMS STREET 
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    City                 |    EAST ORANGE
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    State                |    NJ
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    Zip                  |    07017-2213
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    Country              |    US
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    Telephone            |    973-675-1900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    73 ALLEN ST. EAST 
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    City                 |    PISCATAWAY
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    State                |    NJ
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    Zip                  |    08854
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    Country              |    US
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    Telephone            |    973-207-2378
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    Fax                  |    
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    26NJ00370300
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    License Number State |    NJ
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