Provider Demographics
NPI:1700361771
Name:OSBORNE, ABBY (BSN RN)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 W 48TH ST APT 5W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1288
Mailing Address - Country:US
Mailing Address - Phone:205-612-3997
Mailing Address - Fax:
Practice Address - Street 1:3203 39TH AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2203
Practice Address - Country:US
Practice Address - Phone:718-729-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY756761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse