Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 017100-1 | NY |
N | 2251E1300X | Electrophysiology, Clinical | 017100-1 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 017100-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 017100-1 | NY |
NPI | 1255647426 |
---|---|
Provider Name | Dr. Osama E Omran |
First Address | Staten Island, NY 10301-4538 |
Second Address | Staten Island, NY 10301-4538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |