Provider Demographics
NPI:1770269847
Name:ODONDI, CAROLYNE AKOTH
Entity type:Individual
Prefix:
First Name:CAROLYNE
Middle Name:AKOTH
Last Name:ODONDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLYNE
Other - Middle Name:AWUOR
Other - Last Name:ODONDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 DUTCHESS LANDING RD APT B407
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1673
Mailing Address - Country:US
Mailing Address - Phone:845-453-4705
Mailing Address - Fax:
Practice Address - Street 1:243 NORTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1172
Practice Address - Country:US
Practice Address - Phone:845-790-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY698249163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine