Provider Demographics
NPI:1104148923
Name:OSNA PLLC
Entity type:Organization
Organization Name:OSNA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AUTHORITY
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENGLERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-385-2115
Mailing Address - Street 1:PO BOX 271429
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1429
Mailing Address - Country:US
Mailing Address - Phone:602-772-3800
Mailing Address - Fax:
Practice Address - Street 1:10250 N 92ND ST
Practice Address - Street 2:SUITE 308
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4510
Practice Address - Country:US
Practice Address - Phone:480-947-3700
Practice Address - Fax:480-941-1640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSNA PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-20
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDQ4501OtherRAILROAD MEDICARE PTAN
AZZ136714Medicare PIN
AZDQ4501OtherRAILROAD MEDICARE PTAN