Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samuel Okechukwu

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1396412763

Samuel Okechukwu is a Nurse Practitioner in Passaic, New Jersey. Qualified in 2021, 5 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
5
Licensed in
NJ
In the registry since
2021

Practice location Address checks out

350 Blvd
Passaic, NJ 07055-2840
Phone: (862) 596-4831
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ01197300 (NJ)

Record details

NPI number1396412763
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 24, 2021
Last updated in NPPESAugust 24, 2021
Certification dateAugust 24, 2021
Mailing address350 Boulevard, Passaic, NJ 07055-2840

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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