Provider Demographics
NPI:1083882120
Name:OSBORNE, CATHY MARIE
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:MARIE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARTERIAL SHOPPING PLAZA, RTE 30A
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-0000
Mailing Address - Country:US
Mailing Address - Phone:518-725-8661
Mailing Address - Fax:518-725-1129
Practice Address - Street 1:ARTERIAL SHOPPING PLAZA, RTE 30A
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-0000
Practice Address - Country:US
Practice Address - Phone:518-725-8661
Practice Address - Fax:518-725-1129
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist