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General NPI Number Information
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NPI Number | 1043464704
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Entity Type | Individual
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Provider Name | SANDY B. NOSSEIR MD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 127 CHURCH RD
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City | MARLTON
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State | NJ
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Zip | 08053-9402
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Country | US
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Telephone | 856-607-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 127 CHURCH RD SUITE 600
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City | MARLTON
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State | NJ
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Zip | 08053-9402
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Country | US
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Telephone | 856-607-2273
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Fax |
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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 | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | 25MA09185300
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License Number State | NJ
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