Healthcare Provider Details

I. General information

NPI: 1407914633
Provider Name (Legal Business Name): NELSON L. TURCIOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 CRANBURY RD STE A
EAST BRUNSWICK NJ
08816-5405
US

IV. Provider business mailing address

282 E MAIN ST
SOMERVILLE NJ
08876-3006
US

V. Phone/Fax

Practice location:
  • Phone: 908-526-5212
  • Fax: 908-526-5477
Mailing address:
  • Phone: 908-526-5212
  • Fax: 908-526-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number25MA04435400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: