Provider Demographics
NPI:1023746674
Name:ONMED PROFESSIONAL SERVICES PA
Entity type:Organization
Organization Name:ONMED PROFESSIONAL SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-546-5214
Mailing Address - Street 1:7 RENAISSANCE SQ FL 5
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3056
Mailing Address - Country:US
Mailing Address - Phone:866-567-4565
Mailing Address - Fax:
Practice Address - Street 1:512 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-2418
Practice Address - Country:US
Practice Address - Phone:727-601-4513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty