Healthcare Provider Details

I. General information

NPI: 1023046109
Provider Name (Legal Business Name): YASEMIN OSMAN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 MARATHON PKWY
DOUGLASTON NY
11362-2041
US

IV. Provider business mailing address

6040 MARATHON PKWY
DOUGLASTON NY
11362-2041
US

V. Phone/Fax

Practice location:
  • Phone: 718-631-3778
  • Fax: 718-281-2055
Mailing address:
  • Phone: 718-631-3778
  • Fax: 718-281-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1802671
License Number StateNY

VIII. Authorized Official

Name: YASEMIN OSMAN
Title or Position: MD
Credential: MD
Phone: 718-631-3778