Provider Demographics
NPI:1285115170
Name:OSSAI, AZUKA CHRISTIAN
Entity type:Individual
Prefix:
First Name:AZUKA
Middle Name:CHRISTIAN
Last Name:OSSAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 TALL PNES
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-7609
Mailing Address - Country:US
Mailing Address - Phone:856-213-3770
Mailing Address - Fax:
Practice Address - Street 1:2005 TALL PNES
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-7609
Practice Address - Country:US
Practice Address - Phone:856-213-3770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst