Provider Demographics
NPI:1841206026
Name:OSOFSKY, ROBERT HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HARRIS
Last Name:OSOFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:299 CAREW ST
Mailing Address - Street 2:STE 330
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2397
Mailing Address - Country:US
Mailing Address - Phone:413-734-4918
Mailing Address - Fax:413-734-4919
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:STE 330
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2397
Practice Address - Country:US
Practice Address - Phone:413-734-4918
Practice Address - Fax:413-734-4919
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39759207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15134OtherHEALTH NEW ENGLAND
MA2045206Medicaid
MA725030OtherTUFTS
MA15134OtherHEALTH NEW ENGLAND
A67700Medicare UPIN