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NPI Code Detail

MEDICARE: OSLER AT HOME INC

MEDICARE: OSLER AT HOME INC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1447764717
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSLER AT HOME INC
Provider Business Mailing Address
First Line : 288 BOULEVARD STE 2
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-426-6554
Fax Number :
Provider Business Practice Location Address
First Line : 288 BOULEVARD STE 2
Second Line :
City : HASBROUCK HEIGHTS
State : NJ
Zip : 07604-1319
Country : US
Telephone Number : 201-426-6554
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. THOMAS S BELLAVIA
Credential : MD
Telephone Number : 201-426-6554
Provider Enumeration Date : 11/25/2017
Last Update Date : 11/25/2017

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Directions to “OSLER AT HOME INC ” Practice Location

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