MEDICARE: VICTOR OGBUAGU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1417198235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR OGBUAGU

Provider Business Mailing Address
First Line	:	1025 E 228TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-4819
Country	:	US
Telephone Number	:	914-325-4031
Fax Number	:	347-920-5144

Provider Business Practice Location Address
First Line	:	1025 E 228TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-4819
Country	:	US
Telephone Number	:	914-325-4031
Fax Number	:	347-920-5144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2009
Last Update Date	:	03/09/2009

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Directions to “ VICTOR OGBUAGU ” Practice Location

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