Provider Demographics
NPI:1043240690
Name:OSMAN, SOPHIA A
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:A
Last Name:OSMAN
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 1:4880 RIDGERUN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229
Mailing Address - Country:US
Mailing Address - Phone:614-394-3914
Mailing Address - Fax:
Practice Address - Street 1:4880 RIDGERUN DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6418
Practice Address - Country:US
Practice Address - Phone:614-394-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2602197Medicaid