Provider Demographics
NPI:1699569954
Name:OAK DYNAMIC HEALTHCARE
Entity type:Organization
Organization Name:OAK DYNAMIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OVIGWENRAYE
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:EMECHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-541-9238
Mailing Address - Street 1:360 FLORENCE AVE, HILLSIDE, NJ
Mailing Address - Street 2:111
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:360 FLORENCE AVE, HILLSIDE, NJ
Practice Address - Street 2:111
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205
Practice Address - Country:US
Practice Address - Phone:917-541-9238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health