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General NPI Number Information
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NPI Number | 1891913141
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Entity Type | Organization
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Legal Business Name | RAPHAEL OSHEROFF, M.D, P.A.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 385 LAKEVIEW AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-4035
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Country | US
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Telephone | 973-928-2777
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Fax | 973-928-2776
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Provider Business Mailing Address
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Address Line | 2 HAMILTON AVE
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City | CRANFORD
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State | NJ
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Zip | 07016-2427
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Country | US
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Telephone | 973-928-2777
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Fax | 973-928-2776
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAPHAEL J OSHEROFF
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Credential | M.D.
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Telephone | 973-928-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 175535-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA06156400
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License Number State | NJ
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