Provider Demographics
NPI:1699873265
Name:UKPABI, OKORO CHIGBOH (MD)
Entity type:Individual
Prefix:DR
First Name:OKORO
Middle Name:CHIGBOH
Last Name:UKPABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 BALDWIN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-6931
Mailing Address - Country:US
Mailing Address - Phone:516-481-2120
Mailing Address - Fax:516-481-5030
Practice Address - Street 1:229 BALDWIN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-6931
Practice Address - Country:US
Practice Address - Phone:516-481-2120
Practice Address - Fax:516-481-5030
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147641174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00951895Medicaid
NY55D491Medicare ID - Type Unspecified
NY00951895Medicaid