Healthcare Provider Details

I. General information

NPI: 1215999040
Provider Name (Legal Business Name): VERONICA NGOZI OGULA PMHNP/BC. DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W MAIN ST
EAST ISLIP NY
11730-2337
US

IV. Provider business mailing address

76 ASH STREET
VALLEY STREAM NY
11580
US

V. Phone/Fax

Practice location:
  • Phone: 917-825-8463
  • Fax: 516-706-4908
Mailing address:
  • Phone: 516-812-7849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400956
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: