Provider Demographics
NPI:1265751010
Name:OFFIAH, ODIRI (FNP)
Entity type:Individual
Prefix:MRS
First Name:ODIRI
Middle Name:
Last Name:OFFIAH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ODIRI
Other - Middle Name:
Other - Last Name:EYAGBESHARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 CLASSON AVE
Mailing Address - Street 2:APT#13H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 CLASSON AVE
Practice Address - Street 2:APT#13H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4342
Practice Address - Country:US
Practice Address - Phone:917-292-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily