| Organization Name: | OSLER HEALTH IPA LLC |
| NPI Number: | 1578939443 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS S BELLAVIA (PRESIDENT) |
| Mailing Address: | 288 Boulevard Hasbrouck Heights |
| State: | NJ US |
| Postal Code: | 076041318 |
| Phone Number: | 2012886858 |
| Fax Number: | 2012884575 |
| NPI Enumeration Date: | 08/14/2015 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25MA02163600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |