Provider Demographics
NPI:1043464704
Name:NOSSEIR, SANDY B (MD)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:B
Last Name:NOSSEIR
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 1:127 CHURCH RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9402
Mailing Address - Country:US
Mailing Address - Phone:856-607-2273
Mailing Address - Fax:
Practice Address - Street 1:127 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9402
Practice Address - Country:US
Practice Address - Phone:856-607-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA091853002088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2088F0040XOtherTAXONOMY CODE