1306692975 NPI number — MS. ABIGAEL KYRA ARCEO OSENA M.D.

Table of content: MS. ABIGAEL KYRA ARCEO OSENA M.D. (NPI 1306692975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306692975 NPI number — MS. ABIGAEL KYRA ARCEO OSENA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSENA
Provider First Name:
ABIGAEL KYRA
Provider Middle Name:
ARCEO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306692975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
79-01 BROADWAY
Provider Second Line Business Mailing Address:
ROOM C10-12 - PSYCHIATRY DEPARTMENT
Provider Business Mailing Address City Name:
ELMHURST, QUEENS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-334-3542
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79-01 BROADWAY
Provider Second Line Business Practice Location Address:
ROOM C10-12 - PSYCHIATRY DEPARTMENT
Provider Business Practice Location Address City Name:
ELMHURST, QUEENS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-334-3542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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