Provider Demographics
NPI:1922139708
Name:OSOFSKY, DOUGLAS K (DPM)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:K
Last Name:OSOFSKY
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 1:2350 RT 22
Mailing Address - Street 2:BOX 1E
Mailing Address - City:DOVER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522
Mailing Address - Country:US
Mailing Address - Phone:845-877-3668
Mailing Address - Fax:845-692-2844
Practice Address - Street 1:2350 RT 22
Practice Address - Street 2:
Practice Address - City:DOVER PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12522
Practice Address - Country:US
Practice Address - Phone:845-877-3668
Practice Address - Fax:845-692-2844
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN35941213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00843536Medicaid
P37541Medicare PIN