Individual
THEODORE OSMOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
375 N MAIN ST, SUITE C-3, WILLIAMSTOWN, NJ 08094-1481
(856) 875-0810
(856) 875-7116
Mailing address
9 MENKAR AVE, SEWELL, NJ 08080-2409
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA00529400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1547736
AMERIHEALTH
NJ
01
—
2230033
FIRST HEALTH
NJ
01
—
4940585
CIGNA PPO
NJ
Enumeration date
10/11/2006
Last updated
07/08/2007
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