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Individual
NICHOLAS OSBORNE
Active
Individual
NICHOLAS OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012935
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03053725
—
NY
01
—
9590793
INDEPENDENT HEALTH
NY
Enumeration date
10/28/2008
Last updated
12/29/2008
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