Provider Demographics
NPI:1386747681
Name:ANYOKU, AZUKA (MD)
Entity type:Individual
Prefix:
First Name:AZUKA
Middle Name:
Last Name:ANYOKU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 STEELE HILL RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1415
Mailing Address - Country:US
Mailing Address - Phone:516-435-5235
Mailing Address - Fax:718-455-0999
Practice Address - Street 1:1420 BUSHWICK AVE
Practice Address - Street 2:STE 154
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1422
Practice Address - Country:US
Practice Address - Phone:718-455-3036
Practice Address - Fax:718-455-0999
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02267545Medicaid
066AB1Medicare ID - Type Unspecified
NY02267545Medicaid