Provider Demographics
NPI:1184466930
Name:OSOWICK, JENNIFER (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:OSOWICK
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 1:3 EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:SPARROW BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12780-5428
Mailing Address - Country:US
Mailing Address - Phone:682-459-4367
Mailing Address - Fax:
Practice Address - Street 1:3 EAGLE CT
Practice Address - Street 2:
Practice Address - City:SPARROW BUSH
Practice Address - State:NY
Practice Address - Zip Code:12780-5428
Practice Address - Country:US
Practice Address - Phone:682-459-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY808511-01163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice