Provider Demographics
NPI:1265958599
Name:OMARI, STEPHEN N (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:N
Last Name:OMARI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2237
Mailing Address - Country:US
Mailing Address - Phone:856-504-3150
Mailing Address - Fax:856-504-3157
Practice Address - Street 1:306 W SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2237
Practice Address - Country:US
Practice Address - Phone:856-504-3150
Practice Address - Fax:856-504-3157
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01747300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist