Individual
GEORGE ROBERT FAUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5000
Mailing address
668 ROSSVILLE AVE, STATEN ISLAND, NY 10309-1706
(732) 293-6222
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NR19660500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2024
Last updated
04/08/2025
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