Provider Demographics
NPI:1891380713
Name:ODARI, NEREAH (RN)
Entity Type:Individual
Prefix:
First Name:NEREAH
Middle Name:
Last Name:ODARI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 BRONX RIVER RD APT 8D
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1744
Mailing Address - Country:US
Mailing Address - Phone:845-505-4203
Mailing Address - Fax:
Practice Address - Street 1:687 BRONX RIVER RD APT 8D
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1744
Practice Address - Country:US
Practice Address - Phone:845-505-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY745579163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse