Provider Demographics
NPI:1104321009
Name:OSELLA, AVERY ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:AVERY
Middle Name:ROSE
Last Name:OSELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6142
Mailing Address - Country:US
Mailing Address - Phone:207-860-4090
Mailing Address - Fax:207-860-4098
Practice Address - Street 1:131 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6142
Practice Address - Country:US
Practice Address - Phone:207-860-4090
Practice Address - Fax:207-860-4098
Is Sole Proprietor?:No
Enumeration Date:2018-03-24
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD25160207R00000X, 207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine