Healthcare Provider Details

I. General information

NPI: 1679728059
Provider Name (Legal Business Name): CHERYL DENISE OGDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 6TH AVE
TROY NY
12180-3478
US

IV. Provider business mailing address

1801 6TH AVE
TROY NY
12180-3478
US

V. Phone/Fax

Practice location:
  • Phone: 518-274-5143
  • Fax: 518-691-9317
Mailing address:
  • Phone: 518-274-5143
  • Fax: 518-691-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number781589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: