Provider Demographics
NPI:1134233067
Name:OSIKA, LINDA A (PA-C)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:OSIKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:DIGIAMBATTISTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:41 GERMANTOWN RD
Mailing Address - Street 2:SUITE B01
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4087
Mailing Address - Country:US
Mailing Address - Phone:203-207-3300
Mailing Address - Fax:203-207-3310
Practice Address - Street 1:41 GERMANTOWN RD
Practice Address - Street 2:SUITE B01
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4087
Practice Address - Country:US
Practice Address - Phone:203-207-3300
Practice Address - Fax:203-207-3310
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S62096Medicare UPIN