Provider Demographics
NPI:1194032540
Name:OKEKE, STELLA
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name: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 1:34 METROPOLITAN OVAL
Mailing Address - Street 2:#4H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6608
Mailing Address - Country:US
Mailing Address - Phone:347-621-4072
Mailing Address - Fax:
Practice Address - Street 1:3041 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5126
Practice Address - Country:US
Practice Address - Phone:712-615-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY567464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse