MEDICARE: OSAHANOR VANESSA OSAGIE NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	F0117137	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	408631	NY

General Provider Information

NPI Number	:	1841722139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAHANOR VANESSA OSAGIE NP-C

Provider Business Mailing Address
First Line	:	339 TARRYTOWN RD # 1007
Second Line	:
City	:	ELMSFORD
State	:	NY
Zip	:	10523-3417
Country	:	US
Telephone Number	:	914-222-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	339 TARRYTOWN RD # 1007
Second Line	:
City	:	ELMSFORD
State	:	NY
Zip	:	10523-3417
Country	:	US
Telephone Number	:	914-222-3613
Fax Number	:	914-222-8893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	02/04/2026

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