GERALD NISSENBAUM MD NPI 1144240565

NPI Information

NPI: 1144240565
Provider Name: GERALD NISSENBAUM, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

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

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
1	2085R0202X	Radiology	Diagnostic Radiology	25MA03764500	NEW JERSEY	Yes

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
1	114547C48	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY
2	D18729	MEDICARE UPIN
3	3673901	MEDICAID	NEW 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: 4/28/2024

NPI Synchronization or Removal

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