Provider Demographics
NPI:1972689834
Name:ELTOUNY, OSAMA KHADER (PHD, PT)
Entity Type:Individual
Prefix:MR
First Name:OSAMA
Middle Name:KHADER
Last Name:ELTOUNY
Suffix:
Gender:M
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 MORRIS AVE
Mailing Address - Street 2:SUITE 6 AND 7
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6036
Mailing Address - Country:US
Mailing Address - Phone:908-764-9562
Mailing Address - Fax:
Practice Address - Street 1:2143 MORRIS AVE
Practice Address - Street 2:SUITE 6 AND 7
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6036
Practice Address - Country:US
Practice Address - Phone:908-764-9562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00253700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist