Individual
DR. MIRIAM SUSAN ANANNAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1255 RARITAN RD, CLARK, NJ 07066-1200
(848) 206-0072
(848) 206-0078
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA0675500
NJ
207P00000X
Emergency Medicine Physician
MA67554
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8174601
—
NJ
Enumeration date
12/04/2006
Last updated
06/12/2023
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