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NPI Code Detail

MEDICARE: MR. CHIMA OGUEKWE MS OTR/L

MEDICARE: MR. CHIMA OGUEKWE MS OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerRT003908PA
2225X00000XOccupational TherapistOC012241PA

General Provider Information

NPI Number : 1790818904
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHIMA OGUEKWE MS OTR/L
Provider Business Mailing Address
First Line : 815 CHESTER PIKE
Second Line :
City : PROSPECT PARK
State : PA
Zip : 19076-2322
Country : US
Telephone Number : 610-586-6262
Fax Number :
Provider Business Practice Location Address
First Line : 815 CHESTER PIKE
Second Line :
City : PROSPECT PARK
State : PA
Zip : 19076-2322
Country : US
Telephone Number : 610-586-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 08/12/2014

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