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
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052848800
—
DC
05
—
420375500
—
MD
Enumeration date
09/22/2009
Last updated
03/09/2026
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