Provider Demographics
NPI:1215266580
Name:ONGOCO, JOSEPH S
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:ONGOCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 ALAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-3206
Mailing Address - Country:US
Mailing Address - Phone:317-796-0800
Mailing Address - Fax:317-796-0800
Practice Address - Street 1:4001 FORD RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2833
Practice Address - Country:US
Practice Address - Phone:317-388-0800
Practice Address - Fax:317-388-0805
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031259-1171W00000X
PAPT020474208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No171W00000XOther Service ProvidersContractor