Healthcare Provider Details

I. General information

NPI: 1205155090
Provider Name (Legal Business Name): GLADYS OZOUDE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19550 JAMAICA AVE STE B
HOLLIS NY
11423-2664
US

IV. Provider business mailing address

19550 JAMAICA AVE
HOLLIS NY
11423-2664
US

V. Phone/Fax

Practice location:
  • Phone: 347-545-2806
  • Fax: 718-776-5005
Mailing address:
  • Phone: 718-776-9899
  • Fax: 718-776-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number301109
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number654504
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number342244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: