Provider Demographics
NPI:1619067071
Name:OSWARI, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
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 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:639 COOPER ST
Practice Address - Street 2:LEAP ACADEMY HEALTH CENTER
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1116
Practice Address - Country:US
Practice Address - Phone:856-614-5603
Practice Address - Fax:856-614-5638
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA67986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH11345Medicare UPIN