Provider Demographics
NPI:1477707867
Name:ADJEKUGHELE, JUDE OGHENEGUEKE (PT)
Entity Type:Individual
Prefix:MR
First Name:JUDE
Middle Name:OGHENEGUEKE
Last Name:ADJEKUGHELE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 LINCOLN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-576-0314
Mailing Address - Fax:914-576-1256
Practice Address - Street 1:273 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-3619
Practice Address - Country:US
Practice Address - Phone:914-576-0314
Practice Address - Fax:914-576-1256
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013417-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist