Provider Demographics
NPI:1265651996
Name:OJUGO, ELIZABETH (MS, DPT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:OJUGO
Suffix:
Gender:F
Credentials:MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 BROAD ST
Mailing Address - Street 2:FLOOR 3 , SUITE 2
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3346
Mailing Address - Country:US
Mailing Address - Phone:973-471-3500
Mailing Address - Fax:973-471-3504
Practice Address - Street 1:1135 BROAD ST
Practice Address - Street 2:FLOOR 3 , SUITE 2
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3346
Practice Address - Country:US
Practice Address - Phone:973-471-3500
Practice Address - Fax:973-471-3504
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01043300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11224882OtherCAQH
7243404OtherAETNA
7243404OtherAETNA