Provider Demographics
NPI:1275190548
Name:AGLAN, OSAMA SAMIR BADR (MD)
Entity Type:Individual
Prefix:
First Name:OSAMA
Middle Name:SAMIR BADR
Last Name:AGLAN
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:#22, ZAHRAA
Mailing Address - Street 2:
Mailing Address - City:NASR CITY
Mailing Address - State:CAIRO
Mailing Address - Zip Code:11528
Mailing Address - Country:EG
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-919-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2020-02-26
Deactivation Date:2020-01-16
Deactivation Code:
Reactivation Date:2020-02-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program