Provider Demographics
NPI:1922080464
Name:OSIECKI, STEPHANIE T (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:T
Last Name:OSIECKI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:264 ELM ST
Mailing Address - Street 2:SUITES 10&12
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2857
Mailing Address - Country:US
Mailing Address - Phone:413-586-1100
Mailing Address - Fax:413-584-7062
Practice Address - Street 1:264 ELM ST
Practice Address - Street 2:SUITES 10&12
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2857
Practice Address - Country:US
Practice Address - Phone:413-586-1100
Practice Address - Fax:413-584-7062
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-10-23
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Provider Licenses
StateLicense IDTaxonomies
MA203867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3207749Medicaid
MA042104788OtherUNICARE/GIC
MA14912OtherHEALTH NEW ENGLAND
MAA30786OtherBCBS MA
MA7137629OtherAETNA
MA042104788OtherNORTH AMERICAN PREFERRED
MA042104788OtherNORTHEAST HEALTH DIRECT
MA042104788OtherPRIVATE HEALTH CARE SYS.
MA467855OtherTUFTS
MA042104788OtherCONSOLIDATED
MA042104788OtherNORTHEAST HEALTHCARE ALLI
MA203867OtherCONNECTICARE
MA9560323OtherCIGNA
MA042104788OtherGREAT-WEST HEALTH PLAN
MAAA24783OtherHARVARD PILGRIM HEALTHCAR
MA042104788OtherNORTHEAST HEALTHCARE ALLI
MA9560323OtherCIGNA