Provider Demographics
NPI:1588231955
Name:OSETKOWSKI, KATHRYN LYNDA (ANP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LYNDA
Last Name:OSETKOWSKI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 JAGOW RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2944
Mailing Address - Country:US
Mailing Address - Phone:716-525-5581
Mailing Address - Fax:
Practice Address - Street 1:3332 WALDEN AVE
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2400
Practice Address - Country:US
Practice Address - Phone:716-668-7051
Practice Address - Fax:716-668-7069
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310201-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health