Provider Demographics
NPI:1477975134
Name:OSINUGA, ADEWALE (RN)
Entity Type:Individual
Prefix:
First Name:ADEWALE
Middle Name:
Last Name:OSINUGA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 REGIS DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1428
Mailing Address - Country:US
Mailing Address - Phone:646-633-6375
Mailing Address - Fax:212-417-2097
Practice Address - Street 1:265 REGIS DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1428
Practice Address - Country:US
Practice Address - Phone:646-633-6375
Practice Address - Fax:212-417-2097
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605326163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse