Provider Demographics
NPI:1457159196
Name:OSOBI, CHARITY
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:OSOBI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BURNETT AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2916
Mailing Address - Country:US
Mailing Address - Phone:862-368-2160
Mailing Address - Fax:
Practice Address - Street 1:37 BURNETT AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2916
Practice Address - Country:US
Practice Address - Phone:862-368-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program