Healthcare Provider Details

I. General information

NPI: 1992951164
Provider Name (Legal Business Name): DEBORAH ISSA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 FOREST AVE
PARAMUS NJ
07652-5428
US

IV. Provider business mailing address

277 FOREST AVE
PARAMUS NJ
07652-5428
US

V. Phone/Fax

Practice location:
  • Phone: 201-986-1881
  • Fax:
Mailing address:
  • Phone: 201-986-1881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00156400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: