Provider Demographics
NPI:1326315995
Name:OSIELSKI, JAMES S (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:OSIELSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13945 W BROOK HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-8334
Mailing Address - Country:US
Mailing Address - Phone:414-482-3515
Mailing Address - Fax:414-482-9680
Practice Address - Street 1:3109 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2935
Practice Address - Country:US
Practice Address - Phone:414-482-3515
Practice Address - Fax:414-482-9680
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11529-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist