Provider Demographics
NPI:1598086258
Name:NJERU, MUSA N (MD)
Entity Type:Individual
Prefix:
First Name:MUSA
Middle Name:N
Last Name:NJERU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3435 70TH ST
Mailing Address - Street 2:APT 111
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1055
Mailing Address - Country:US
Mailing Address - Phone:609-442-2393
Mailing Address - Fax:
Practice Address - Street 1:12507 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1411
Practice Address - Country:US
Practice Address - Phone:347-460-4253
Practice Address - Fax:718-355-9650
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY264130207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1598086258Medicaid
NJ190934YCGAMedicare PIN
NJ0241482Medicaid
NJ190934ZC79Medicare PIN