Healthcare Provider Details

I. General information

NPI: 1851569479
Provider Name (Legal Business Name): CHRISTIAN O OGAGA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2008
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 NORTH AVE
NEW ROCHELLE NY
10801-2628
US

IV. Provider business mailing address

255 HUGUENOT ST APT 204
NEW ROCHELLE NY
10801-6387
US

V. Phone/Fax

Practice location:
  • Phone: 914-235-6475
  • Fax:
Mailing address:
  • Phone: 914-813-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number045262-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: