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Individual
MR. EBENEZER OGUNTUASE
Active
Individual
MR. EBENEZER OGUNTUASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00598500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000146
US HEALTHCARE
NJ
01
—
2115735000
AMERIHEALTH
NJ
01
—
5294643
AETNA US HEALTHCARE
NJ
01
—
532743
BLUE SHIELD OF PA
PA
01
—
P00040938
RAILROAD MEDICARE
NJ
Enumeration date
02/22/2006
Last updated
05/11/2011
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