MEDICARE: CARLOS TILGHMAN-OSBORNE PHD

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	103TC0700X	Clinical Psychologist	PS01662	RI

General Provider Information

NPI Number	:	1417141771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS TILGHMAN-OSBORNE PHD

Provider Business Mailing Address
First Line	:	1130 TEN ROD RD STE C206
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4127
Country	:	US
Telephone Number	:	401-294-0451
Fax Number	:	401-799-5938

Provider Business Practice Location Address
First Line	:	1130 TEN ROD RD STE C206
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4127
Country	:	US
Telephone Number	:	401-799-5938
Fax Number	:	401-267-4990

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

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	05/09/2025

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