=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720519523
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NAUREEN OSMAN MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2017
-----------------------------------------------------
Last Update Date | 04/10/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 734 PARK AVE
-----------------------------------------------------
City | HUNTINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11743-3900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-271-1640
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30 PINE DR N
-----------------------------------------------------
City | ROSLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11576-2037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-561-7761
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | 304031-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------