Provider Demographics
NPI:1790001972
Name:OSGOOD, DANIEL JOSEF
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEF
Last Name:OSGOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JERSEY ST
Mailing Address - Street 2:APT 506
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4811
Mailing Address - Country:US
Mailing Address - Phone:617-595-7477
Mailing Address - Fax:
Practice Address - Street 1:100 JERSEY ST
Practice Address - Street 2:APT 506
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-4811
Practice Address - Country:US
Practice Address - Phone:617-595-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program