Basic Information
Provider Information
NPI: 1174895288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSWALD
FirstName: ELIZABETH
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2:  
City: NEW YORK
State: NY
PostalCode: 100296574
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Practice Location
Address1: 1 GUSTAVE L LEVY PL
Address2:  
City: NEW YORK
State: NY
PostalCode: 100296574
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/04/2012
LastUpdateDate: 02/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X430633NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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