Provider Demographics
NPI:1851148332
Name:OKORONKWO, OBIAKU UDOKA (MBCHB)
Entity type:Individual
Prefix:DR
First Name:OBIAKU
Middle Name:UDOKA
Last Name:OKORONKWO
Suffix:
Gender:F
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MASSACHUSETTS AVENUE
Mailing Address - Street 2:4TH FLOOR, SUITE 470
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:617-638-8540
Mailing Address - Fax:617-638-8535
Practice Address - Street 1:801 MASSACHUSETTS AVENUE
Practice Address - Street 2:4TH FLOOR, SUITE 470
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8540
Practice Address - Fax:617-638-8535
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2025-09-12
Deactivation Date:2024-12-18
Deactivation Code:
Reactivation Date:2025-09-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program