Healthcare Provider Details

I. General information

NPI: 1770012346
Provider Name (Legal Business Name): SAMIA Y OSMAN MD, MPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

IV. Provider business mailing address

184 LIBERTY ST
NEW HAVEN CT
06519-1625
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-9704
  • Fax:
Mailing address:
  • Phone: 617-329-1869
  • Fax: 857-770-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number1.084798
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number272621
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1.084798
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: