Provider Demographics
NPI:1548835564
Name:OSAGIE, OSAYAMO WINNIE
Entity type:Individual
Prefix:
First Name:OSAYAMO
Middle Name:WINNIE
Last Name:OSAGIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 WARBURTON AVE APT 6R
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1616
Mailing Address - Country:US
Mailing Address - Phone:917-612-9341
Mailing Address - Fax:
Practice Address - Street 1:679 WARBURTON AVE APT 6R
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1616
Practice Address - Country:US
Practice Address - Phone:917-612-9341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle