Provider Demographics
NPI:1922080464
Name:OSIECKI, STEPHANIE T (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:T
Last Name:OSIECKI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 CAMBRIDGE ST FL 14
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2509
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:888-732-8119
Practice Address - Street 1:100 CAMBRIDGE ST FL 14
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2509
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:888-732-8119
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2024-06-17
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Provider Licenses
StateLicense IDTaxonomies
MA203867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA30786OtherBCBS MA
MA203867OtherCONNECTICARE
MA9560323OtherCIGNA
MA042104788OtherCONSOLIDATED
MA042104788OtherNORTHEAST HEALTH DIRECT
MA042104788OtherUNICARE/GIC
MA3207749Medicaid
MA467855OtherTUFTS
MA042104788OtherGREAT-WEST HEALTH PLAN
MA042104788OtherNORTH AMERICAN PREFERRED
MA042104788OtherPRIVATE HEALTH CARE SYS.
MA14912OtherHEALTH NEW ENGLAND
MA7137629OtherAETNA
MA042104788OtherNORTHEAST HEALTHCARE ALLI
MAAA24783OtherHARVARD PILGRIM HEALTHCAR
MA042104788OtherNORTHEAST HEALTHCARE ALLI
MA9560323OtherCIGNA