Provider Demographics
NPI:1326566704
Name:ONGLENGCO, JERICHO MIKHAIL S (PT)
Entity Type:Individual
Prefix:MR
First Name:JERICHO MIKHAIL
Middle Name:S
Last Name:ONGLENGCO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:JERICHO MIKHAIL
Other - Middle Name:S
Other - Last Name:ONGLENGCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:31 E 32ND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5595
Mailing Address - Country:US
Mailing Address - Phone:212-759-2282
Mailing Address - Fax:212-379-2123
Practice Address - Street 1:161 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1205
Practice Address - Country:US
Practice Address - Phone:646-847-1686
Practice Address - Fax:212-379-2084
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039997-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist