Individual
MR. MARTIN OSEMWENGIE OVIASOGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 472-4471
(315) 999-1377
Mailing address
1033 JAMES ST, SYRACUSE, NY 13203-2740
(315) 472-4471
(315) 999-1377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
699520
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402562
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F402562
NY
Other
Enumeration date
08/17/2017
Last updated
11/19/2025
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