Healthcare Provider Details

I. General information

NPI: 1215840657
Provider Name (Legal Business Name): CYNTHIA A OGBOVOH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7403 COMMONWEALTH BLVD
BELLEROSE NY
11426-1839
US

IV. Provider business mailing address

7403 COMMONWEALTH BLVD
BELLEROSE NY
11426-1839
US

V. Phone/Fax

Practice location:
  • Phone: 516-603-4963
  • Fax:
Mailing address:
  • Phone: 718-264-4605
  • Fax: 718-264-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number409199
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: