Healthcare Provider Details

I. General information

NPI: 1164796249
Provider Name (Legal Business Name): VICTORIA CHIKA OGBEJESI NP-C, PMHNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 07/25/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 RIDGE RD
MADISON CT
06443-2377
US

IV. Provider business mailing address

93 RIDGE RD
MADISON CT
06443-2377
US

V. Phone/Fax

Practice location:
  • Phone: 203-606-4813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4873
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number004873
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: