Provider Demographics
NPI:1902070535
Name:FERNANDES, OSHELLE ALANAH (OTA)
Entity Type:Individual
Prefix:MS
First Name:OSHELLE
Middle Name:ALANAH
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TROY AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1820
Mailing Address - Country:US
Mailing Address - Phone:718-312-2837
Mailing Address - Fax:
Practice Address - Street 1:1979 MARCUS AVENUE
Practice Address - Street 2:SUITE 204 GLOBAL COMMUNICATION SERVICES, INC.
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-327-4681
Practice Address - Fax:516-327-4684
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003486-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor