Healthcare Provider Details

I. General information

NPI: 1225993892
Provider Name (Legal Business Name): OGO AC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 PARK AVE
CONGERS NY
10920-1519
US

IV. Provider business mailing address

19 PARK AVE
CONGERS NY
10920-1519
US

V. Phone/Fax

Practice location:
  • Phone: 845-893-2747
  • Fax:
Mailing address:
  • Phone: 845-893-2747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: LEONA DEVIN
Title or Position: PRESIDENT
Credential:
Phone: 845-893-2747