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General NPI Number Information
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NPI Number | 1629653563
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Entity Type | Organization
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Legal Business Name | OMEGA PHYSICIANS LLC
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 103 OLD MARLTON PIKE STE 124
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City | MEDFORD
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State | NJ
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Zip | 08055-8772
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Country | US
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Telephone | 888-575-9162
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Fax |
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Provider Business Mailing Address
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Address Line | 103 OLD MARLTON PIKE STE 124
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City | MEDFORD
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State | NJ
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Zip | 08055-8772
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Country | US
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Telephone | 888-575-9162
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Fax | 980-987-4391
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Authorized Official
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Title or Position | OWNER
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Name | NAGASASIKANTH R MOPURI
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Credential | MD
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Telephone | 404-702-0995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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