Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 345111 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | 345111 | NY |
NPI | 1073159679 |
---|---|
Provider Name | Avellina Ihuaku Okafor |
First Address | Rochester, NY 14615-3716 |
Second Address | Rochester, NY 14615-3716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2019 |
Last Update Date | 19/11/2019 |