Individual
SAMUEL OKONTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21714 MERRICK BLVD, LAURELTON, NY 11413-1917
(718) 712-1428
(718) 712-1736
Mailing address
21714 MERRICK BLVD, LAURELTON, NY 11413-1917
(718) 712-1428
(718) 712-1736
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
177073
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125951
BCBS
NY
Enumeration date
06/01/2006
Last updated
09/08/2016
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