Provider Demographics
NPI:1932215357
Name:OGUAGHA, CHIKA (MD)
Entity Type:Individual
Prefix:
First Name:CHIKA
Middle Name:
Last Name:OGUAGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 STERLING PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3307
Mailing Address - Country:US
Mailing Address - Phone:718-783-6860
Mailing Address - Fax:718-783-6861
Practice Address - Street 1:342 FLATBUSH AVE
Practice Address - Street 2:NEPHROLOGY FOUNDATION OF BROOKLYN
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4902
Practice Address - Country:US
Practice Address - Phone:718-857-3000
Practice Address - Fax:718-857-6210
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00863736Medicaid
NY00863736Medicaid
NY40A361Medicare ID - Type Unspecified