Individual
MR. GODWIN OKPOMO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2962 WICKHAM AVE, BRONX, NY 10469-3324
(646) 384-0252
Mailing address
2962 WICKHAM AVE, BRONX, NY 10469-3324
(646) 384-0252
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401152-1
NY
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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