Basic Information
| Provider Information | |||||||||
| NPI: | 1205985371 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSHALIM | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | OWSHALIMPUR | ||||||||
| OtherFirstName: | DAVID | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 50 DEVONSHIRE CIR | ||||||||
| Address2: | DAVID OSHALIM | ||||||||
| City: | PENFIELD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853880548 | ||||||||
| FaxNumber: | 5854618580 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 WESTFALL RD | ||||||||
| Address2: | FINGER LAKE DDSO | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854618588 | ||||||||
| FaxNumber: | 5854618580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 153021 | NY | X | Allopathic & Osteopathic Physicians | Family Medicine | 207U00000X | 153021 | NY | X | Allopathic & Osteopathic Physicians | Nuclear Medicine |
No ID Information.