Provider Demographics
NPI:1184662777
Name:TOSSOUNIAN, NORA Z (MD)
Entity type:Individual
Prefix:DR
First Name:NORA
Middle Name:Z
Last Name:TOSSOUNIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:AMBULATORY CLINIC
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:160 ESSEX ST STE 102
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2701
Practice Address - Country:US
Practice Address - Phone:551-996-8111
Practice Address - Fax:551-996-8445
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06787500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056358Medicare ID - Type Unspecified
G85231Medicare UPIN