Provider Demographics
NPI:1740250851
Name:OSEI-TUTU, ERNEST PAUL (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:PAUL
Last Name:OSEI-TUTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ERNEST
Other - Middle Name:PAUL
Other - Last Name:OSEI-TUTU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1760 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2552
Mailing Address - Country:US
Mailing Address - Phone:732-947-9486
Mailing Address - Fax:732-947-9617
Practice Address - Street 1:42 PARSONAGE RD STE B
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2547
Practice Address - Country:US
Practice Address - Phone:732-947-9486
Practice Address - Fax:732-947-9617
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168405207R00000X
NJ25MA08756400207RA0401X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0516295Medicaid