Individual
OLGA KOSICHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
29 HOMER ST, STATEN ISLAND, NY 10301-3101
(646) 643-4492
Mailing address
29 HOMER ST, STATEN ISLAND, NY 10301-3101
(646) 643-4492
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405558-01
NY
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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