Provider Demographics
NPI:1568555290
Name:FURY, MARY A (DO)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:FURY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BETHANY ROAD
Mailing Address - Street 2:BUILDING 5 SUITE 65
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730
Mailing Address - Country:US
Mailing Address - Phone:732-264-0700
Mailing Address - Fax:732-264-1414
Practice Address - Street 1:ONE BETHANY ROAD
Practice Address - Street 2:BUILDING 5 SUITE 65
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730
Practice Address - Country:US
Practice Address - Phone:732-264-0700
Practice Address - Fax:732-264-1414
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08014500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MB08014500OtherMEDICAL LICENSE