Provider Demographics
NPI:1568050599
Name:MUJICA, OSCAR MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:MICHAEL
Last Name:MUJICA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 STOCKTON RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7812
Mailing Address - Country:US
Mailing Address - Phone:908-477-4860
Mailing Address - Fax:
Practice Address - Street 1:355 US HIGHWAY 22 E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3577
Practice Address - Country:US
Practice Address - Phone:908-325-3000
Practice Address - Fax:908-325-3232
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01983500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty