Provider Demographics
NPI:1306134697
Name:OJONG, PETER BATE (CRNP)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:BATE
Last Name:OJONG
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 3RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-2072
Mailing Address - Country:US
Mailing Address - Phone:484-526-4700
Mailing Address - Fax:484-526-2074
Practice Address - Street 1:511 E 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-2072
Practice Address - Country:US
Practice Address - Phone:484-526-4700
Practice Address - Fax:484-526-2074
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR884084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily