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Individual

ITOHAN OTASOWIE PAT-OSAGIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
1500 WATERS PL, BRONX, NY 10461-2723
(929) 348-3464
Mailing address
590 EAGLE AVE, BRONX, NY 10455-2915
(917) 349-2367

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
626959
NY

Other

Enumeration date
01/06/2021
Last updated
01/06/2021
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