Provider Demographics
NPI:1174871602
Name:OKOBI, FAITH CYNTHIA (SERVICE COORDINATOR)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:CYNTHIA
Last Name:OKOBI
Suffix:
Gender:F
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16809 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-3463
Mailing Address - Country:US
Mailing Address - Phone:917-627-6009
Mailing Address - Fax:718-523-0013
Practice Address - Street 1:21426 41ST AVE STE BAYSIDE
Practice Address - Street 2:SUITE 130
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2159
Practice Address - Country:US
Practice Address - Phone:718-631-1110
Practice Address - Fax:718-631-1314
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator