Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F337873-1 | NY |
NPI | 1003255670 |
---|---|
Provider Name | Ifeoma Brenda Okpaleke |
First Address | Bronx, NY 10458-1000 |
Second Address | New York, NY 10001-6708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 29/03/2018 |