Provider Demographics
NPI:1437213188
Name:OSENTOSKI, MONICA ZIEZULEWICZ (RPH)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:ZIEZULEWICZ
Last Name:OSENTOSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1227
Mailing Address - Country:US
Mailing Address - Phone:810-326-4717
Mailing Address - Fax:810-326-4717
Practice Address - Street 1:4100 RIVER RD
Practice Address - Street 2:
Practice Address - City:EAST CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-2909
Practice Address - Country:US
Practice Address - Phone:810-326-4717
Practice Address - Fax:810-329-8926
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist