Healthcare Provider Details

I. General information

NPI: 1386734291
Provider Name (Legal Business Name): OGELUE C EZEIFE-UGORJI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COOPER PLZ DEPT OF ANESTHESIA
CAMDEN NJ
08103-1461
US

IV. Provider business mailing address

1 FEDERAL ST STE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-342-2425
  • Fax: 856-968-8239
Mailing address:
  • Phone: 856-356-4924
  • Fax: 856-356-4710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN528650L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ00266400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: