- Practice location
- 34 Mountain Blvd, Warren, NJ 07059-2640
- Phone
- 347-307-1381
- Fax
- —
- Last updated
- March 5, 2025
Miriam Kerolus Fanouse is a Dentist based in Warren, NJ. Miriam Kerolus Fanouse practices in Warren, NJ. The NPI Number for Miriam Kerolus Fanouse is 1356761456 and holds a License No. 22di02942100 (NJ). The current practice location address for Miriam Kerolus Fanouse is 34 Mountain Blvd, Warren, NJ 07059-2640 and can be reached out via phone at 347-307-1381.
Provider Profile Details
- NPI Number
- 1356761456
- Provider Name
- Miriam Kerolus Fanouse
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 34 Mountain Blvd, Warren, NJ 07059-2640
- Phone Number
- 347-307-1381
- Primary Taxonomy
- Dentist · 122300000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 16, 2014
- Last Update Date
- March 5, 2025
- Certification Date
- March 5, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 34 Mountain Blvd
Warren, NJ 07059-2640 - City
- Warren
- State
- New Jersey
- Zip
- 07059-2640
- Phone Number
- 347-307-1381
Provider Business Mailing Address Details
- Address
- 46 Bartlett Ave
Staten Island, NY 10312-2462 - City
- Staten Island
- State
- NY
- Zip
- 10312-2462
- Phone Number
- 347-307-1381
License Information
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (2)
- 22di02942100
- License State (2)
- NJ
- Taxonomy (2)
- Dentist · 122300000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Warren, NJ
View all Dentists in Warren →Frequently Asked Questions
What is the NPI number of Miriam K Fanouse?
The NPI number of Miriam K Fanouse is 1356761456. It was assigned on April 16, 2014 and is currently active in the NPPES registry.
What is the specialty of Miriam K Fanouse?
Miriam K Fanouse is registered under the primary taxonomy Dentist (code 122300000X), licensed in NJ under license number 22di02942100.
Where does Miriam K Fanouse practice?
The practice location is 34 Mountain Blvd, Warren, NJ 07059-2640. The office can be reached at 347-307-1381 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1356761456 directly on the NPPES registry website.