Provider Demographics
NPI:1417033465
Name:OSMAN, IMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IMAN
Middle Name:
Last Name:OSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 INTREPID PL
Mailing Address - Street 2:PORT LIBERTE
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-5485
Mailing Address - Country:US
Mailing Address - Phone:212-263-9076
Mailing Address - Fax:212-263-9090
Practice Address - Street 1:1430 FIRST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-9076
Practice Address - Fax:212-263-9090
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229083-1208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology