Healthcare Provider Details

I. General information

NPI: 1225113814
Provider Name (Legal Business Name): OGEDI A OHAJEKWE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N 5TH AVE
MOUNT VERNON NY
10550-1269
US

IV. Provider business mailing address

2 OVERHILL RD STE 355
SCARSDALE NY
10583-5338
US

V. Phone/Fax

Practice location:
  • Phone: 914-668-2266
  • Fax: 914-668-1611
Mailing address:
  • Phone: 914-725-1036
  • Fax: 914-668-1611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number193038
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: