Provider Demographics
NPI:1619771946
Name:OSBORNE, CHLOE SIMONE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:SIMONE
Last Name:OSBORNE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 LANGSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8051
Mailing Address - Country:US
Mailing Address - Phone:404-547-7394
Mailing Address - Fax:
Practice Address - Street 1:601 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3117
Practice Address - Country:US
Practice Address - Phone:315-701-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program