Provider Demographics
NPI:1508924317
Name:OSMAN, ABUZAFAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:ABUZAFAR
Middle Name:M
Last Name:OSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 PATRIOTS RD
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3318
Mailing Address - Country:US
Mailing Address - Phone:631-444-8608
Mailing Address - Fax:631-444-8778
Practice Address - Street 1:100 PATRIOTS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3318
Practice Address - Country:US
Practice Address - Phone:631-444-8608
Practice Address - Fax:631-444-8778
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2010-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY203634207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW79881Medicaid
NYBN6065886Medicare ID - Type Unspecified
NYW79881Medicaid