Healthcare Provider Details

I. General information

NPI: 1386507168
Provider Name (Legal Business Name): BISMA MUNIR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 MAIN ST
EDISON NJ
08837-3418
US

IV. Provider business mailing address

17 DEL RAY RD
EGG HARBOR TOWNSHIP NJ
08234-3107
US

V. Phone/Fax

Practice location:
  • Phone: 732-582-0400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ15463800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: