Provider Demographics
NPI:1396948444
Name:OSETEK, LOIS E (MS CCC A)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:E
Last Name:OSETEK
Suffix:
Gender:F
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414432
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-4432
Mailing Address - Country:US
Mailing Address - Phone:413-748-9000
Mailing Address - Fax:413-748-6812
Practice Address - Street 1:271 CAREW ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2377
Practice Address - Country:US
Practice Address - Phone:413-748-9000
Practice Address - Fax:413-748-6812
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1212249Medicaid
MA1010085Medicaid
MA220066Medicare ID - Type UnspecifiedMEDICARE
MA22T066Medicare Oscar/Certification