Provider Demographics
NPI:1801969357
Name:O'SHEA, JOAN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:F
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:512 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4803
Mailing Address - Country:US
Mailing Address - Phone:856-797-9161
Mailing Address - Fax:856-797-3637
Practice Address - Street 1:512 LIPPINCOTT DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4803
Practice Address - Country:US
Practice Address - Phone:856-797-9161
Practice Address - Fax:856-797-3637
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06654500207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG58841Medicare UPIN