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Organization
ERGO OCCMED LLC
Active
Organization
ERGO OCCMED LLC
Active
Parent organization
ERGO OCCMED LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ERGO OCCMED LLC
Authorized official
OLU PETER EZEANI (OWNER/PROVIDER)
(301) 567-6400
Entity
Organization
Contact information
Practice address
6196 OXON HILL RD, SUITE 120, OXON HILL, MD 20745-3100
(301) 567-6400
(202) 318-8174
Mailing address
6196 OXON HILL RD STE 120, OXON HILL, MD 20745-3138
(301) 567-6400
(202) 318-8174
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19226
MD
225100000X
Physical Therapist
PT870468
DC
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/22/2009
Last updated
03/09/2026
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