Healthcare Provider Details

I. General information

NPI: 1992668727
Provider Name (Legal Business Name): JEANIFER CHINYE UWAECHIE-OSORDI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 W 37TH ST
NEW YORK NY
10018-4202
US

IV. Provider business mailing address

220 BEACH 30TH ST FL 1
FAR ROCKAWAY NY
11691-2009
US

V. Phone/Fax

Practice location:
  • Phone: 914-734-8600
  • Fax:
Mailing address:
  • Phone: 914-734-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF407565
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: