Healthcare Provider Details
I. General information
NPI: 1346471877
Provider Name (Legal Business Name): ENDOCRINE ASSOCIATES OF WESTFIELD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2009
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
552 WESTFIELD AVENUE
WESTFIELD NJ
07090
US
IV. Provider business mailing address
552 WESTFIELD AVENUE
WESTFIELD NJ
07090
US
V. Phone/Fax
- Phone: 908-654-3377
- Fax: 908-654-4044
- Phone: 908-654-3377
- Fax: 908-654-4044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | 25MA02571100 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
ROBERT
A
FUHRMAN
Title or Position: OWNER
Credential: MD, FACP, FACE
Phone: 908-654-3377