Provider Demographics
NPI:1518728856
Name:OKAFOR, CONSTANCE A (APN)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:A
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BADGER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108-3166
Mailing Address - Country:US
Mailing Address - Phone:973-680-6481
Mailing Address - Fax:
Practice Address - Street 1:1250 SHAKESPEARE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-3012
Practice Address - Country:US
Practice Address - Phone:718-583-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14994400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health