MEDICARE: OSAMA MICHAEL

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	183500000X	Pharmacist	066726	NY

General Provider Information

NPI Number	:	1245840719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAMA MICHAEL

Provider Business Mailing Address
First Line	:	180 AVENUE C APT 3
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-8918
Country	:	US
Telephone Number	:	551-232-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5202
Country	:	US
Telephone Number	:	201-659-8492
Fax Number	:

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

Provider Enumeration Date	:	08/08/2020
Last Update Date	:	08/08/2020

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Directions to “ OSAMA MICHAEL ” Practice Location

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