Provider Demographics
NPI:1427360577
Name:NASSAR, RULA (MD)
Entity Type:Individual
Prefix:
First Name:RULA
Middle Name:
Last Name:NASSAR
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 1:2604 CRESTLINE CT.
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:215-590-2437
Mailing Address - Fax:215-590-2768
Practice Address - Street 1:4755 OGLETOWN - STANTON RD
Practice Address - Street 2:MAP SUITE 217
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:908-240-7611
Practice Address - Fax:215-590-2768
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197111208000000X
DEC1-00120432080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics