Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 168405 | NY |
N | 111NI0900X | Internist | 168405 | NY |
Y | 207R00000X | Internist | 25MA08756400 | NJ |
Y | 111NI0900X | Internist | 25MA08756400 | NJ |
N | 207RA0401X | Internist - Addiction Medicine | 25MA08756400 | NJ |
NPI | 1740250851 |
---|---|
Provider Name | Ernest Paul Osei-Tutu |
First Address | Scotch Plains, NJ 07076-2552 |
Second Address | Edison, NJ 08837-2547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 11/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0516295 | (05) | NJ |
A64756 | (02) | NY |