Provider Demographics
NPI:1851476824
Name:OGAWA, AKIKO (ATC)
Entity Type:Individual
Prefix:
First Name:AKIKO
Middle Name:
Last Name:OGAWA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W LAWN DR
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5611
Mailing Address - Country:US
Mailing Address - Phone:305-807-0325
Mailing Address - Fax:
Practice Address - Street 1:1000 RIVER RD
Practice Address - Street 2:H-AT1-01
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1914
Practice Address - Country:US
Practice Address - Phone:201-692-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001351002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer