GERALD NISSENBAUM MD NPI 1144240565

NPI Information

  • NPI: 1144240565
  • Provider Name: GERALD NISSENBAUM, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 1600 HADDON AVE
    CAMDEN, NJ
    ZIP 08103
  • Phone: (888) 609-8116

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NPI Details

Gerald Nissenbaum, MD is a diagnostic radiology radiology in Camden, NJ. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Gerald Nissenbaum, MD NPI is 1144240565. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1600 HADDON AVE
CAMDEN, NJ
ZIP 08103-117
Phone: (888) 609-8116

The enumeration date for this NPI number is 7/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology25MA03764500NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1114547C48MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY
2D18729MEDICARE UPIN
33673901MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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