Provider Demographics
NPI:1821050816
Name:NUNEZ, HELEN L (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:L
Last Name:NUNEZ
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 1:34 CLARK ST
Mailing Address - Street 2:APT A
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-3518
Mailing Address - Country:US
Mailing Address - Phone:973-919-6859
Mailing Address - Fax:
Practice Address - Street 1:190 MEISEL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1830
Practice Address - Country:US
Practice Address - Phone:973-467-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07314200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0090981Medicaid