Individual
MR. OSARIEMEN EDEGBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
400 FORT HILL AVE, CANANDAIGUA, ROCHESTER, NY 14623-1462
(646) 725-3719
Mailing address
517 RICHARDSON RD, ROCHESTER, NY 14623-1239
(646) 725-3719
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
829972
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
829972
NY STATE RN LICENSE
NY
Enumeration date
01/27/2023
Last updated
01/27/2023
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