MEDICARE: ABIGAIL OSBORN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	027818	NY

General Provider Information

NPI Number	:	1174313977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL OSBORN PSYD

Provider Business Mailing Address
First Line	:	401 COMMONS PARK S UNIT 577
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-7138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 MORRIS PARK AVE BLDG 5
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1949
Country	:	US
Telephone Number	:	718-430-3907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	01/13/2026

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