Provider Demographics
NPI:1831169432
Name:OSULA, COLLINS O (MD)
Entity type:Individual
Prefix:
First Name:COLLINS
Middle Name:O
Last Name:OSULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FOOTE AVE
Mailing Address - Street 2:OB/GYN
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-7077
Mailing Address - Country:US
Mailing Address - Phone:716-393-0113
Mailing Address - Fax:716-366-5224
Practice Address - Street 1:17 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7080
Practice Address - Country:US
Practice Address - Phone:716-393-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2103921207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160053539OtherMEDICARE RAILROAD
NY00040430402OtherUNIVERA
NY000913918003OtherBLUE CROSS BLUE SHIELD
NY01861738Medicaid
NY040426004010OtherFIDELIS
NY000000086999OtherGHI HMO
NY0791105OtherINDEPENDENT HEALTH
NY000913918003OtherBLUE CROSS BLUE SHIELD
NY01861738Medicaid
NY00040430402OtherUNIVERA