Individual
MR. CHARLES OSAKIDUWA OMOZUWA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
436 BEACH 36TH ST APT 3, FAR ROCKAWAY, NY 11691-1507
(347) 972-1288
Mailing address
436 BEACH 36TH ST APT 3, FAR ROCKAWAY, NY 11691-1507
(347) 972-1288
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
337790
NY
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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