Provider Demographics
NPI:1447323118
Name:TULSYAN, NIRMAN (MD)
Entity type:Individual
Prefix:DR
First Name:NIRMAN
Middle Name:
Last Name:TULSYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 MADISON AVE STE 220-37
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7358
Mailing Address - Country:US
Mailing Address - Phone:908-400-9805
Mailing Address - Fax:
Practice Address - Street 1:905 ALLWOOD RD STE 105
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1946
Practice Address - Country:US
Practice Address - Phone:908-400-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA080542002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0127396Medicaid
NJ034381Medicare PIN
I20467Medicare UPIN