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General NPI Number Information
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NPI Number | 1003819905
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Entity Type | Individual
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Provider Name | MAYUMI A. MORI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 218 RIDGEDALE AVE
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2109
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Country | US
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Telephone | 973-326-8895
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Fax | 973-326-6805
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Provider Business Mailing Address
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Address Line | 1265 15TH ST APT 11G
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City | FORT LEE
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State | NJ
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Zip | 07024-1958
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Country | US
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Telephone | 973-326-8895
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Fax | 973-326-6805
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA64405
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA06440500
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License Number State | NJ
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