Provider Demographics
NPI:1497059356
Name:OSIJO, JANET O
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:O
Last Name:OSIJO
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 1:1430 SEAGIRT BLVD
Mailing Address - Street 2:5R
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4528
Mailing Address - Country:US
Mailing Address - Phone:347-246-7261
Mailing Address - Fax:
Practice Address - Street 1:1430 SEAGIRT BLVD
Practice Address - Street 2:5R
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4528
Practice Address - Country:US
Practice Address - Phone:347-246-7261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303143164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse