Provider Demographics
NPI:1730617226
Name:UKAEGBU, OGECHI (DC)
Entity type:Individual
Prefix:
First Name:OGECHI
Middle Name:
Last Name:UKAEGBU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5219
Mailing Address - Country:US
Mailing Address - Phone:908-463-2530
Mailing Address - Fax:
Practice Address - Street 1:788 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2584
Practice Address - Country:US
Practice Address - Phone:732-324-4300
Practice Address - Fax:732-324-8211
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00745600111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation