Provider Demographics
NPI:1407260334
Name:GELMAN-NISANOV, FAINA (MD)
Entity Type:Individual
Prefix:DR
First Name:FAINA
Middle Name:
Last Name:GELMAN-NISANOV
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 1:800 KINDERKAMACK RD STE 204S
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1534
Mailing Address - Country:US
Mailing Address - Phone:201-932-2051
Mailing Address - Fax:
Practice Address - Street 1:800 KINDERKAMACK RD STE 204S
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1534
Practice Address - Country:US
Practice Address - Phone:201-932-2051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292188207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology