Provider Demographics
NPI:1194261149
Name:LAHOZ OGANDO, KEYLA J
Entity type:Individual
Prefix:
First Name:KEYLA
Middle Name:J
Last Name:LAHOZ OGANDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 BAILEY AVE
Mailing Address - Street 2:19D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7220
Mailing Address - Country:US
Mailing Address - Phone:845-287-5830
Mailing Address - Fax:
Practice Address - Street 1:2820 BAILEY AVE
Practice Address - Street 2:19D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7220
Practice Address - Country:US
Practice Address - Phone:845-287-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-15
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst