Provider Demographics
NPI:1811194913
Name:OSBORNE, TERRY II (DO)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:OSBORNE
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 NICHOLS ROAD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420
Mailing Address - Country:US
Mailing Address - Phone:978-878-8100
Mailing Address - Fax:978-878-8418
Practice Address - Street 1:326 NICHOLS ROAD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-878-8440
Practice Address - Fax:978-878-8535
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2461242084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry