MEDICARE: DR. JOSEPH OMBALSKY MD

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
1	207V00000X	Obstetrics & Gynecology Physician	25MA07108200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225023302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH OMBALSKY MD

Provider Business Mailing Address
First Line	:	500 GROVE ST
Second Line	:	SUITE 100
City	:	HADDON HEIGHTS
State	:	NJ
Zip	:	08035-1761
Country	:	US
Telephone Number	:	856-796-9200
Fax Number	:	856-796-9397

Provider Business Practice Location Address
First Line	:	1600 HADDON AVE
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-3101
Country	:	US
Telephone Number	:	856-757-3700
Fax Number	:	856-365-7972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	02/11/2016

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