Healthcare Provider Details

I. General information

NPI: 1114052784
Provider Name (Legal Business Name): ROBERT H OSOFSKY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CAREW ST. SUITE 330
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

299 CAREW ST SUITE 330
SPRINGFIELD MA
01104
US

V. Phone/Fax

Practice location:
  • Phone: 413-734-4918
  • Fax: 413-734-4919
Mailing address:
  • Phone: 413-734-4918
  • Fax: 413-734-4919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number39759
License Number StateMA

VIII. Authorized Official

Name: DR. ROBERT H OSOFSKY
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 413-734-4918