Individual
DR. NILS VIESTURS BROLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1474 TANYARD ROAD, SUITE D100, SEWELL, NJ 08080
(856) 566-6265
(856) 566-6185
Mailing address
1474 TANYARD RD STE D100, SEWELL, NJ 08080-4222
(856) 566-6265
(856) 566-6185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB09374700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0473570
—
NJ
01
—
678445
MEDICARE
NJ
Enumeration date
06/29/2011
Last updated
09/11/2025
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