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Individual

MS. OSARENIYE DORCAS EDENAMIGHO II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21 SHERMAN AVE APT 4K, NEW YORK, NY 10040-1822
(929) 478-0817
Mailing address
21 SHERMAN AVE, NEW YORK, NY 10040-1815
(929) 478-0817

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
NY
261QP0905X
State or Local Public Health Clinic/Center
NY
374U00000X
Home Health Aide
Primary
01003186
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1396531042
NY
Enumeration date
01/02/2025
Last updated
05/29/2025
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