Provider Demographics
NPI:1265506489
Name:OSWARI, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:OSWARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 KLOCKNER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2725
Mailing Address - Country:US
Mailing Address - Phone:609-689-2900
Mailing Address - Fax:609-689-2918
Practice Address - Street 1:1799 KLOCKNER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2725
Practice Address - Country:US
Practice Address - Phone:609-689-2900
Practice Address - Fax:609-689-2918
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA71308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8700907Medicaid
NJ8700800OtherMEDICAID GROUP NUMBER
NJ8700800OtherMEDICAID GROUP NUMBER
NJ8700907Medicaid