Provider Demographics
NPI:1548547581
Name:OWUSU, ALICE (RN)
Entity type:Individual
Prefix:MISS
First Name:ALICE
Middle Name:
Last Name:OWUSU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E 159TH ST
Mailing Address - Street 2:APT. 1D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4372
Mailing Address - Country:US
Mailing Address - Phone:646-228-6062
Mailing Address - Fax:
Practice Address - Street 1:320 E 159TH ST
Practice Address - Street 2:APT. 1D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4372
Practice Address - Country:US
Practice Address - Phone:646-228-6062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY599898-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse