Provider Demographics
NPI:1568828531
Name:OSBORNE, JUNE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MRS
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:NEACOSIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:55 CAYUGA LN
Mailing Address - Street 2:
Mailing Address - City:WEST SAND LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12196-2008
Mailing Address - Country:US
Mailing Address - Phone:518-937-9123
Mailing Address - Fax:
Practice Address - Street 1:10B MADISON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7314
Practice Address - Country:US
Practice Address - Phone:518-867-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3851224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant