Provider Demographics
NPI:1922006899
Name:OSIAS, KIMBERLY BETH (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BETH
Last Name:OSIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 4, SUITE I
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2300
Mailing Address - Country:US
Mailing Address - Phone:609-896-0303
Mailing Address - Fax:609-896-0308
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BUILDING 4, SUITE I
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-896-0303
Practice Address - Fax:609-896-0308
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07596100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110533OtherPERSONAL CHOICE
NJP3404564OtherOXFORD
NJ0050768Medicaid
NJ0261928000OtherAMERIHEALTH
NJ2K7470OtherHEALTHNET
NJK5616OtherHORIZON
NJ5680766OtherAETNA
NJ9383692OtherCIGNA
NJ0261928000OtherAMERIHEALTH
NJP3404564OtherOXFORD