Provider Demographics
NPI:1669494985
Name:OSMANSKI, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:OSMANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:935 THORN RUN RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2861
Mailing Address - Country:US
Mailing Address - Phone:412-299-8400
Mailing Address - Fax:412-299-8497
Practice Address - Street 1:935 THORN RUN RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2861
Practice Address - Country:US
Practice Address - Phone:412-299-8400
Practice Address - Fax:412-299-8497
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD028833E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012006050011Medicaid
PA579407Medicare PIN
PA0012006050011Medicaid