Provider Demographics
NPI:1639162001
Name:OSULLIVAN, JANETTE MARY (CNM)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:MARY
Last Name:OSULLIVAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2201
Mailing Address - Country:US
Mailing Address - Phone:718-858-1288
Mailing Address - Fax:
Practice Address - Street 1:1331 E 19TH ST
Practice Address - Street 2:NURSE MIDWIFERY ASSOC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6103
Practice Address - Country:US
Practice Address - Phone:718-375-9268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000528176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife