Provider Demographics
NPI:1780807206
Name:FUHRMAN, MIRIAM (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:
Last Name:FUHRMAN
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 1:680 BROADWAY STE 114
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1526
Mailing Address - Country:US
Mailing Address - Phone:973-742-4747
Mailing Address - Fax:
Practice Address - Street 1:680 BROADWAY STE 114
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1526
Practice Address - Country:US
Practice Address - Phone:973-742-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08613300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08613300OtherNJ STATE LICENSE
NY237106OtherNYS LICENSE
NY02879349Medicaid