Provider Demographics
NPI:1972379899
Name:GRITSISHIN, OKSANA (NP)
Entity Type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:GRITSISHIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:OKSANA
Other - Middle Name:
Other - Last Name:HRYTSYSHYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2323 E 12TH ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4221
Mailing Address - Country:US
Mailing Address - Phone:718-664-7795
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:718-664-7795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311337363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health