Provider Demographics
NPI:1144520594
Name:AWOSIKA, VINCENT
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:AWOSIKA
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 1:5644 N 78TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2145
Mailing Address - Country:US
Mailing Address - Phone:414-324-8244
Mailing Address - Fax:414-463-4176
Practice Address - Street 1:12134 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-4830
Practice Address - Country:US
Practice Address - Phone:141-432-4824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Yes251E00000XAgenciesHome Health