Provider Demographics
NPI:1043693740
Name:OYEOSSI, HAFEZ S (RN, PCCN)
Entity Type:Individual
Prefix:
First Name:HAFEZ
Middle Name:S
Last Name:OYEOSSI
Suffix:
Gender:M
Credentials:RN, PCCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 PARKER ST
Mailing Address - Street 2:APT 5
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4963
Mailing Address - Country:US
Mailing Address - Phone:646-707-9851
Mailing Address - Fax:
Practice Address - Street 1:41 CASTLE POINT RD
Practice Address - Street 2:BUILDING 15
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-7004
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621636163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical