# ERGO OCCMED LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ERGO OCCMED LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720312903
- **Legal business name:** ERGO OCCMED LLC
- **Authorized official:** OLU PETER EZEANI (OWNER/PROVIDER)
- **Authorized official phone:** (301) 567-6400

## Contact information

- **Practice address:** 6196 OXON HILL RD, SUITE 120, OXON HILL, MD 20745-3100
- **Practice address phone:** (301) 567-6400
- **Practice address fax:** (202) 318-8174
- **Mailing address:** 6196 OXON HILL RD STE 120, OXON HILL, MD 20745-3138
- **Mailing address phone:** (301) 567-6400
- **Mailing address fax:** (202) 318-8174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 19226 | MD | Yes |
| 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