Provider Demographics
NPI:1346260858
Name:WOGHIREN, OSAZEE
Entity Type:Individual
Prefix:MR
First Name:OSAZEE
Middle Name:
Last Name:WOGHIREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 CUMMINS HIGHWAY
Mailing Address - Street 2:#1
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131
Mailing Address - Country:US
Mailing Address - Phone:617-469-3574
Mailing Address - Fax:617-469-8782
Practice Address - Street 1:291 CUMMINS HIGHWAY
Practice Address - Street 2:#1
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131
Practice Address - Country:US
Practice Address - Phone:617-469-3574
Practice Address - Fax:617-469-8782
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies