Healthcare Provider Details

I. General information

NPI: 1649307091
Provider Name (Legal Business Name): NAUREEN MEMON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL MEB 312
NEW BRUNSWICK NJ
08901-1928
US

IV. Provider business mailing address

1 ROBERT WOOD JOHNSON PL MEB 312
NEW BRUNSWICK NJ
08901-1928
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-5709
  • Fax: 732-235-6609
Mailing address:
  • Phone: 732-235-5709
  • Fax: 732-235-6609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number25MA08616000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: