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NPI Code Detail

MEDICARE: OSLER MEDICAL GROUP LLC

MEDICARE: OSLER MEDICAL GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1023502952
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSLER MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : 288 BOULEVARD STE 2A
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-288-6781
Fax Number : 201-288-2734
Provider Business Practice Location Address
First Line : 288 BOULEVARD STE 2A
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-288-6781
Fax Number : 201-288-2734
Authorized Official
Title or Position : CHAIRMAN
Name : DR. THOMAS BELLAVIA
Credential : MD
Telephone Number : 201-426-6526
Provider Enumeration Date : 06/14/2018
Last Update Date : 05/14/2019

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Directions to “OSLER MEDICAL GROUP LLC ” Practice Location

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