Provider Demographics
NPI:1730630229
Name:OSAH, ROSALINE (LPN)
Entity type:Individual
Prefix:MISS
First Name:ROSALINE
Middle Name:
Last Name:OSAH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 E 230TH ST
Mailing Address - Street 2:APT 3
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466
Mailing Address - Country:US
Mailing Address - Phone:718-581-7810
Mailing Address - Fax:
Practice Address - Street 1:722 E 230TH ST
Practice Address - Street 2:APT 3
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-4104
Practice Address - Country:US
Practice Address - Phone:718-581-7810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284824-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse