Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | LP-0000136 | DE |
N | 363LA2100X | Nurse Practitioner - Acute Care | SP014467 | PA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | LP-0000136 | DE |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP014467 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | LP-0000136 | DE |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP014467 | PA |
NPI | 1508245853 |
---|---|
Provider Name | Dominick B Osipowicz |
First Address | Newark, DE 19713-2049 |
Second Address | Newark, DE 19718-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2015 |
Last Update Date | 31/05/2017 |