Provider Demographics
NPI:1063928901
Name:PINNOCK-OKEKE, STACYANN
Entity type:Individual
Prefix:
First Name:STACYANN
Middle Name:
Last Name:PINNOCK-OKEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 N FRANKLIN ST STE 211
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3048
Mailing Address - Country:US
Mailing Address - Phone:516-280-5930
Mailing Address - Fax:
Practice Address - Street 1:71 N FRANKLIN ST STE 211
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3048
Practice Address - Country:US
Practice Address - Phone:516-280-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator