MEDICARE: DONNA MARY O'SHEA PT

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	225100000X	Physical Therapist	40QA00603600	NJ

General Provider Information

NPI Number	:	1558513069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARY O'SHEA PT

Provider Business Mailing Address
First Line	:	3007 OCEAN HEIGHTS AVE
Second Line	:	SUITE 101
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-7749
Country	:	US
Telephone Number	:	609-601-9555
Fax Number	:	609-601-9551

Provider Business Practice Location Address
First Line	:	3007 OCEAN HEIGHTS AVE
Second Line	:	SUITE 101
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-7749
Country	:	US
Telephone Number	:	609-601-9555
Fax Number	:	609-601-9551

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

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	10/15/2008

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