Provider Demographics
NPI:1396229506
Name:OJO, TANIA
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:OJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14845 89TH AVE APT 4C
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3564
Mailing Address - Country:US
Mailing Address - Phone:347-251-1199
Mailing Address - Fax:
Practice Address - Street 1:14845 89TH AVE APT 4C
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3564
Practice Address - Country:US
Practice Address - Phone:347-251-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner