Basic Information
| Provider Information | |||||||||
| NPI: | 1871896597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESSA | ||||||||
| FirstName: | OSAMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | GLOVERSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120781203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187735687 | ||||||||
| FaxNumber: | 5187735232 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 EAST STATE STREET | ||||||||
| Address2: | MAB SUITE 106 | ||||||||
| City: | GLOVERSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120781203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187735687 | ||||||||
| FaxNumber: | 5187754192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2010 | ||||||||
| LastUpdateDate: | 10/15/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD453899 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 295284 | NY | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.