Provider Demographics
NPI:1568658334
Name:OCLOO, AMEN K (RN)
Entity type:Individual
Prefix:MS
First Name:AMEN
Middle Name:K
Last Name:OCLOO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-2829
Mailing Address - Country:US
Mailing Address - Phone:631-273-1801
Mailing Address - Fax:631-273-1801
Practice Address - Street 1:216 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-2829
Practice Address - Country:US
Practice Address - Phone:631-273-1801
Practice Address - Fax:631-273-1801
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467779163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse