Provider Demographics
NPI:1538433032
Name:OKIKE, ANGELA CHINWE (DNP)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:CHINWE
Last Name:OKIKE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12520 SUTPHIN BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2340
Mailing Address - Country:US
Mailing Address - Phone:718-322-9086
Mailing Address - Fax:718-529-0852
Practice Address - Street 1:12520 SUTPHIN BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2340
Practice Address - Country:US
Practice Address - Phone:718-322-9086
Practice Address - Fax:718-529-0852
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382175363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04578121Medicaid