Provider Demographics
NPI:1104977453
Name:NUZZO, ROY M (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:M
Last Name:NUZZO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:99 BEAUVOIR AVE
Mailing Address - Street 2:SUITE 750
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3533
Mailing Address - Country:US
Mailing Address - Phone:908-522-5531
Mailing Address - Fax:908-522-5519
Practice Address - Street 1:99 BEAUVOIR AVE
Practice Address - Street 2:SUITE 750
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3533
Practice Address - Country:US
Practice Address - Phone:908-522-5531
Practice Address - Fax:908-522-5519
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NJMA33985207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8023700Medicaid
NJC60675Medicare UPIN