Provider Demographics
NPI:1407914633
Name:TURCIOS, NELSON L (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:L
Last Name:TURCIOS
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 1:282 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3006
Mailing Address - Country:US
Mailing Address - Phone:908-526-5212
Mailing Address - Fax:908-526-5477
Practice Address - Street 1:579 CRANBURY RD STE A
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5405
Practice Address - Country:US
Practice Address - Phone:908-526-5212
Practice Address - Fax:908-526-5477
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA044354002080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA04435400OtherLICENSE
NJ4004001Medicaid
NJ4004001Medicaid
NJ25MA04435400OtherLICENSE