Healthcare Provider Details

I. General information

NPI: 1649241431
Provider Name (Legal Business Name): DANIEL OGWO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3616 HENRY HUDSON PKWY
BRONX NY
10463-1505
US

IV. Provider business mailing address

3616 HENRY HUDSON PKWY
BRONX NY
10463-1505
US

V. Phone/Fax

Practice location:
  • Phone: 347-601-0999
  • Fax: 718-884-8430
Mailing address:
  • Phone: 347-601-0999
  • Fax: 718-884-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberNOO5958
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: