Provider Demographics
NPI:1891815833
Name:OSIT, MICHAEL M (EDD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:OSIT
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3024
Mailing Address - Country:US
Mailing Address - Phone:973-912-9620
Mailing Address - Fax:
Practice Address - Street 1:5 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5650
Practice Address - Country:US
Practice Address - Phone:908-757-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2418103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical