Healthcare Provider Details

I. General information

NPI: 1144255027
Provider Name (Legal Business Name): CLAIRE A MAJISU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 LYONS AVE FL 1 NEWARK BETH ISRAEL MEDICAL CENTER PEDIATRIC CLINIC
NEWARK NJ
07112-2016
US

IV. Provider business mailing address

26 BUTTONWOOD ST
JERSEY CITY NJ
07305-4870
US

V. Phone/Fax

Practice location:
  • Phone: 973-926-7282
  • Fax: 973-923-2978
Mailing address:
  • Phone: 201-333-8149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA074541
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier9013903
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: