Provider Demographics
NPI:1235503640
Name:NWANERI, OGECHI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:OGECHI
Middle Name:
Last Name:NWANERI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2535
Mailing Address - Country:US
Mailing Address - Phone:914-328-3888
Mailing Address - Fax:914-328-2228
Practice Address - Street 1:3010 WESTCHESTER AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2535
Practice Address - Country:US
Practice Address - Phone:914-328-3888
Practice Address - Fax:914-328-2228
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist