Provider Demographics
NPI:1891914511
Name:OSGOOD, CARALEE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:CARALEE
Middle Name:
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:CARALEE
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:101 MAIN STREET
Mailing Address - Street 2:#101
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-396-4514
Mailing Address - Fax:781-395-4778
Practice Address - Street 1:101 MAIN STREET
Practice Address - Street 2:#101
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-396-4514
Practice Address - Fax:781-395-4778
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0598363AM0700X
MAPA2028363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical