MEDICARE: GEORGE H. OEN M.D. & ROSE L.OEN M.D. PA

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	207R00000X	Internal Medicine Physician	MA038079	NJ

General Provider Information

NPI Number	:	1780879049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE H. OEN M.D. & ROSE L.OEN M.D. PA

Provider Business Mailing Address
First Line	:	781 KENNEDY BLVD
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-2804
Country	:	US
Telephone Number	:	201-823-0166
Fax Number	:	201-858-4924

Provider Business Practice Location Address
First Line	:	781 KENNEDY BLVD
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-2804
Country	:	US
Telephone Number	:	201-823-0166
Fax Number	:	201-858-4924

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROSE L OEN
Credential	:	M.D.
Telephone Number	:	201-823-0166

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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