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General NPI Number Information
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NPI Number | 1710511654
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Entity Type | Individual
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Provider Name | KELSEY OSOWSKI
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Gender | Female
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Dates
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Enumeration Date | 03/01/2020
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 701 COOPER RD STE 16
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City | VOORHEES
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State | NJ
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Zip | 08043-8007
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Country | US
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Telephone | 856-429-2224
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Fax | 856-429-1926
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Provider Business Mailing Address
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Address Line | 4170 CITY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1610
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Country | US
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Telephone | 215-871-6772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00594000
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License Number State | NJ
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