Healthcare Provider Details

I. General information

NPI: 1841206026
Provider Name (Legal Business Name): ROBERT HARRIS OSOFSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CAREW ST STE 330
SPRINGFIELD MA
01104-2397
US

IV. Provider business mailing address

299 CAREW ST STE 330
SPRINGFIELD MA
01104-2397
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:
Title or Position:
Credential:
Phone: