Healthcare Provider Details

I. General information

NPI: 1710133277
Provider Name (Legal Business Name): NINA MAOUELAININ D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DRESHER RD STE 203
HORSHAM PA
19044-2232
US

IV. Provider business mailing address

601 DRESHER RD STE 203
HORSHAM PA
19044-2232
US

V. Phone/Fax

Practice location:
  • Phone: 610-723-7202
  • Fax: 833-973-5641
Mailing address:
  • Phone: 610-723-7202
  • Fax: 833-973-5641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS014135
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS014135
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS014135
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: