Individual
OBI N NWASOKWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22001 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2140
(718) 479-7808
(718) 479-7491
Mailing address
12 LINDEN BLVD, GREAT NECK, NY 11021-1142
(718) 479-7808
(718) 479-7491
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
169721
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0061136
GHI
NY
05
—
01045743
—
NY
Enumeration date
06/22/2006
Last updated
09/27/2016
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