Provider Demographics
NPI:1780144097
Name:KOSYK, OLGA
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:KOSYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 NW 1ST DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9200
Mailing Address - Country:US
Mailing Address - Phone:215-609-7488
Mailing Address - Fax:
Practice Address - Street 1:4234 NW 1ST DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9200
Practice Address - Country:US
Practice Address - Phone:215-609-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9375997163WL0100X
FLAPRN11024524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty