Healthcare Provider Details

I. General information

NPI: 1821801762
Provider Name (Legal Business Name): JANET OWUSU FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1434 WILLIAMSBRIDGE RD
BRONX NY
10461-2507
US

IV. Provider business mailing address

1434 WILLIAMSBRIDGE RD
BRONX NY
10461-2507
US

V. Phone/Fax

Practice location:
  • Phone: 718-561-2800
  • Fax:
Mailing address:
  • Phone: 718-561-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF355657
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: