Provider Demographics
NPI:1174011712
Name:OCHIAGHA, CHIEDOZIE KINGSLEY (RN,BSN,DON)
Entity Type:Individual
Prefix:
First Name:CHIEDOZIE
Middle Name:KINGSLEY
Last Name:OCHIAGHA
Suffix:
Gender:M
Credentials:RN,BSN,DON
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1150 1ST AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1316
Mailing Address - Country:US
Mailing Address - Phone:267-262-1093
Mailing Address - Fax:215-754-4442
Practice Address - Street 1:1150 1ST AVE STE 501
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1316
Practice Address - Country:US
Practice Address - Phone:267-262-1093
Practice Address - Fax:215-754-4442
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator