Provider Demographics
NPI:1538356464
Name:OSUJI, PASCAL IHEANYICHUKWU (COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:PASCAL
Middle Name:IHEANYICHUKWU
Last Name:OSUJI
Suffix:
Gender:M
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-2631
Mailing Address - Country:US
Mailing Address - Phone:267-974-6150
Mailing Address - Fax:215-735-6995
Practice Address - Street 1:1235 PINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5945
Practice Address - Country:US
Practice Address - Phone:215-735-8199
Practice Address - Fax:215-735-6995
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000439101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101Y00000XOtherTAXONOMY