Provider Demographics
NPI:1053309195
Name:FELLUS, JONATHAN L (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:L
Last Name:FELLUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:131 MADISON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7360
Mailing Address - Country:US
Mailing Address - Phone:973-787-7402
Mailing Address - Fax:973-944-2333
Practice Address - Street 1:227 RT 206 NORTH
Practice Address - Street 2:BLDG 2 SUITE 101
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836
Practice Address - Country:US
Practice Address - Phone:732-494-7600
Practice Address - Fax:732-494-7611
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2023-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA066164002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology