Provider Demographics
NPI:1164204608
Name:OSADZE, ILONA (CRNP)
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:OSADZE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2600
Mailing Address - Country:US
Mailing Address - Phone:347-893-2207
Mailing Address - Fax:
Practice Address - Street 1:882 HENRY AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2600
Practice Address - Country:US
Practice Address - Phone:347-893-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program