Provider Demographics
NPI:1376739888
Name:FLEURANTIN, JEAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:JOSEPH
Last Name:FLEURANTIN
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 1:14 OAK TREE CT
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3767
Mailing Address - Country:US
Mailing Address - Phone:609-330-5288
Mailing Address - Fax:609-267-8831
Practice Address - Street 1:310 WOODSTOWN RD
Practice Address - Street 2:MEMORIAL HOSPITAL OF SALEM COUNTY
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-935-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04248900207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ444428B2EMedicare PIN
NJB54690Medicare UPIN