Provider Demographics
NPI:1477008688
Name:OCHIENG, MOSES (MS)
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:
Last Name:OCHIENG
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5065 WYNNEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2442
Mailing Address - Country:US
Mailing Address - Phone:215-921-1520
Mailing Address - Fax:610-688-8632
Practice Address - Street 1:5065 WYNNEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2442
Practice Address - Country:US
Practice Address - Phone:215-921-1520
Practice Address - Fax:610-688-8632
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist