Healthcare Provider Details

I. General information

NPI: 1427360577
Provider Name (Legal Business Name): RULA NASSAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN - STANTON RD MAP SUITE 217
NEWARK DE
19713
US

IV. Provider business mailing address

2604 CRESTLINE CT.
GLEN MILLS PA
19342
US

V. Phone/Fax

Practice location:
  • Phone: 908-240-7611
  • Fax: 215-590-2768
Mailing address:
  • Phone: 215-590-2437
  • Fax: 215-590-2768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT197111
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberC1-0012043
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: