Miriam Kerolus Fanouse
NPI #1356761456 in Warren, New Jersey
Provider Information
- NPI Number
- 1356761456
- Entity Type
- Individual
- Name
- Miriam Kerolus Fanouse
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Enumeration Date
- Apr 16, 2014
- Last Updated
- Mar 5, 2025
Practice Location
- Address
- 34 MOUNTAIN BLVD
- City
- Warren
- State
- New Jersey
- ZIP Code
- 07059-2640
- Phone
- (347) 307-1381
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Dentist |
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