Provider Demographics
NPI:1417257932
Name:IGBINOSUN, OSARUMEN (DPT)
Entity Type:Individual
Prefix:
First Name:OSARUMEN
Middle Name:
Last Name:IGBINOSUN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-4210
Mailing Address - Country:US
Mailing Address - Phone:848-467-0383
Mailing Address - Fax:
Practice Address - Street 1:408 W SCOTT AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-4210
Practice Address - Country:US
Practice Address - Phone:848-467-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist