Provider Demographics
NPI:1063575686
Name:OSAYI, ALCIRA
Entity type:Individual
Prefix:MRS
First Name:ALCIRA
Middle Name:
Last Name:OSAYI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALCIRA
Other - Middle Name:
Other - Last Name:TEXIDOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2255 SATELLITE BLVD
Mailing Address - Street 2:E-106
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-6221
Mailing Address - Country:US
Mailing Address - Phone:678-957-0019
Mailing Address - Fax:678-957-0019
Practice Address - Street 1:2255 SATELLITE BLVD
Practice Address - Street 2:E-106
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-6221
Practice Address - Country:US
Practice Address - Phone:678-957-0019
Practice Address - Fax:678-957-0019
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator