Provider Demographics
NPI:1700674645
Name:UDEKWE, SOMTOCHI
Entity type:Individual
Prefix:
First Name:SOMTOCHI
Middle Name:
Last Name:UDEKWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOMTOCHI
Other - Middle Name:
Other - Last Name:UDEKWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18 VAN WINKLE ST APT A
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-6277
Mailing Address - Country:US
Mailing Address - Phone:214-892-3681
Mailing Address - Fax:
Practice Address - Street 1:3010 W 33RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1404
Practice Address - Country:US
Practice Address - Phone:718-996-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP131526207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine