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General NPI Number Information
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NPI Number | 1548249063
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Entity Type | Individual
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Provider Name | TOBY B HUSSERL M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 2164 HIGHWAY 35 BLDG A
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City | SEA GIRT
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State | NJ
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Zip | 08750-1013
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Country | US
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Telephone | 732-974-0404
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Fax | 732-449-4271
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Provider Business Mailing Address
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Address Line | 2164 HIGHWAY 35 BLDG A
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City | SEA GIRT
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State | NJ
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Zip | 08750-1013
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Country | US
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Telephone | 732-974-0404
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Fax | 732-449-4271
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MA47634
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License Number State | NJ
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