Provider Demographics
NPI:1710650122
Name:OGOKE, CHIZOBA HEATHER (OD)
Entity Type:Individual
Prefix:DR
First Name:CHIZOBA
Middle Name:HEATHER
Last Name:OGOKE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CHARLES ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4740
Mailing Address - Country:US
Mailing Address - Phone:862-944-4994
Mailing Address - Fax:
Practice Address - Street 1:22 OLD SHORT HILLS RD STE LL-1
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5604
Practice Address - Country:US
Practice Address - Phone:973-422-1230
Practice Address - Fax:973-422-1236
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ27OA00715300152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program