Provider Demographics
NPI:1154964773
Name:NAHUM, GERARD G (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:G
Last Name:NAHUM
Suffix:
Gender:M
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:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-0159
Mailing Address - Country:US
Mailing Address - Phone:240-535-7882
Mailing Address - Fax:
Practice Address - Street 1:29 CANAL XING
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2419
Practice Address - Country:US
Practice Address - Phone:973-262-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-27
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800983207V00000X
CAG56447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology