Provider Demographics
NPI:1790809507
Name:OSMANSKI, PETER DAMIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:DAMIAN
Last Name:OSMANSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HARWOOD CT
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4121
Mailing Address - Country:US
Mailing Address - Phone:914-723-7724
Mailing Address - Fax:914-347-2730
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:SUITE 314
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4121
Practice Address - Country:US
Practice Address - Phone:914-723-7724
Practice Address - Fax:914-347-2730
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004267213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3-01157840-2Medicaid
NY26960HAOtherGHI PROVIDER NUMBER
NYT30302Medicare UPIN
NY3-01157840-2Medicaid