Provider Demographics
NPI:1285722868
Name:OKAFOR, JOANA O (MD)
Entity type:Individual
Prefix:DR
First Name:JOANA
Middle Name:O
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOANA
Other - Middle Name:O
Other - Last Name:SEA OKAFOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2369
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07019-2369
Mailing Address - Country:US
Mailing Address - Phone:973-674-6990
Mailing Address - Fax:973-674-6680
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2207
Practice Address - Country:US
Practice Address - Phone:973-674-6990
Practice Address - Fax:973-674-6680
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA39036NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4003608Medicaid
NJ521128Medicare PIN
NJC56859Medicare UPIN