Provider Demographics
NPI:1841425196
Name:NUSSBAUM, CHARLOTTE SIMONE (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:SIMONE
Last Name:NUSSBAUM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:103 OLD MARLTON PIKE STE 203
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8772
Mailing Address - Country:US
Mailing Address - Phone:609-969-4844
Mailing Address - Fax:609-969-4255
Practice Address - Street 1:103 OLD MARLTON PIKE STE 203
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:609-969-4844
Practice Address - Fax:609-969-4255
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09337600202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine