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Individual

GREGORY C OKORONGWU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYCH NP

Contact information

Practice address
729 LIBERTY AVE, BROOKLYN, NY 11208-2221
(347) 520-3033
(929) 290-0328
Mailing address
9917 AVENUE J, BROOKLYN, NY 11236-4015
(347) 520-3033

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F40340901
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06595880
NY
Enumeration date
06/16/2021
Last updated
06/27/2022
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