Oxenberg, Jacqueline Clare
Oxenberg, Jacqueline Clare is an individual health care provider with primary practice located at 1000 East Mountain Blvd. , Wilkes-Barre PA 18711-3762. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgical Oncology is her primary health care specialty. Oxenberg, Jacqueline Clare can be contacted via phone (570) 808-2340.Contact Information
Primary practice address
1000 East Mountain Blvd.
Wilkes-Barre PA 18711-3762
Phone: (570) 808-2340
Fax: (570) 808-7904
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 263687 | New York |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | OS014772 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | OT012136 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | OS014772 | Pennsylvania |
Profile Details
| NPI number | 1669629689 |
|---|---|
| LBN Legal business name | Oxenberg, Jacqueline Clare |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 20th, 2008 |
| Last updated | Jul 30th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669629689 | NPPES |
| Pennsylvania | MEDICAID | 102920739 |
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