Basic Information
| Provider Information | |||||||||
| NPI: | 1902892326 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSEI | ||||||||
| FirstName: | CLEMENT | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 20 GRAND ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WARWICK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109901035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8459873952 | ||||||||
| FaxNumber: | 8459875979 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 CROSFIELD AVE | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | WEST NYACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109942226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453535600 | ||||||||
| FaxNumber: | 8453535668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2005 | ||||||||
| LastUpdateDate: | 03/15/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 1319150 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 0D0737 | 01 | HEALTHNET OF NORTHEAST | OTHER | 132995699 | 01 | FIDEUS (MEDICAID HMO) | OTHER | 1902892326 | 01 | NPI | OTHER | 132998699 | 01 | HORIZON HEALTHCARE OF NY | OTHER | 132995699 | 01 | FAM HEALTH PLUS(HUDSON HP | OTHER | 132995699 | 01 | INDECS(ORANGE-ULSTER SCHL | OTHER | 327611 | 01 | BC/BS EMPIRE | OTHER | 4286895 | 01 | AETNA | OTHER | 132995699 | 01 | LOCAL 1199 | OTHER | 2900089 | 01 | GHI | OTHER | 132995699 | 01 | BEECH STREET NETWORK | OTHER | 132995699 | 01 | CIGNA PPO | OTHER | 132995699 | 01 | MAGNACARE PPO | OTHER | 535171006 | 01 | CIGNA HMO, POS | OTHER | OX140P | 01 | HIP | OTHER | 00533000 | 05 | NY | MEDICAID | 123212 | 01 | AETNA/USHC | OTHER | 132995699 | 01 | HEALTHNOW | OTHER | 132995699 | 01 | HUDSON HEALTH PLAN | OTHER |