MEDICARE: JOHN OJEDA

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	225200000X	Physical Therapy Assistant	40QB00421800	NJ

General Provider Information

NPI Number	:	1962341586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN OJEDA

Provider Business Mailing Address
First Line	:	68 BEECH ST
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-3005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 BLOOMFIELD AVE
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003
Country	:	US
Telephone Number	:	973-750-0880
Fax Number	:

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

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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Directions to “ JOHN OJEDA ” Practice Location

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