Provider Demographics
NPI:1083669584
Name:OSEKOWSKY, HENRY J (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:J
Last Name:OSEKOWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2473
Mailing Address - Country:US
Mailing Address - Phone:651-385-6180
Mailing Address - Fax:651-385-6195
Practice Address - Street 1:426 WEST AVE
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2473
Practice Address - Country:US
Practice Address - Phone:651-385-6180
Practice Address - Fax:651-385-6195
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN153612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
120042OtherU-CARE
7064609OtherAETNA
01014562OtherPREFERRED ONE
855661014562OtherPREFERREDONE ADMINISTRATI
15-49117OtherMEDICA
61Q72OSOtherBX/BS
01014562OtherPREFERRED ONE