Provider Demographics
NPI:1639978711
Name:OSAGHAE, BENDEL O (CEO)
Entity type:Individual
Prefix:
First Name:BENDEL
Middle Name:O
Last Name:OSAGHAE
Suffix:
Gender:
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PRINCE EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3232
Mailing Address - Country:US
Mailing Address - Phone:856-625-0102
Mailing Address - Fax:
Practice Address - Street 1:5 PRINCE EDWARD DR
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-3232
Practice Address - Country:US
Practice Address - Phone:856-625-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management