Basic Information
Provider Information
NPI: 1932493764
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FUSEINI
FirstName: NURAIN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 GROVE ST STE 100
Address2:  
City: HADDON HEIGHTS
State: NJ
PostalCode: 080351761
CountryCode: US
TelephoneNumber: 8567969200
FaxNumber: 8567969397
Practice Location
Address1: 1601 HADDON AVE
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081033109
CountryCode: US
TelephoneNumber: 8567573700
FaxNumber: 8563657972
Other Information
ProviderEnumerationDate: 06/09/2011
LastUpdateDate: 10/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X25MA10142200NJY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home