Healthcare Provider Details

I. General information

NPI: 1023481827
Provider Name (Legal Business Name): EMILY A OSGOOD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 LOMB MEMORIAL DR # 23A
ROCHESTER NY
14623-5608
US

IV. Provider business mailing address

117 LOMB MEMORIAL DR # 23A
ROCHESTER NY
14623-5608
US

V. Phone/Fax

Practice location:
  • Phone: 585-475-2255
  • Fax:
Mailing address:
  • Phone: 585-475-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF340131-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: