Individual
NISHITH BHATTACHARYYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2130 MILLBURN AVENUE, PEDIATRIC SURGERY GROUP, MAPLEWOOD, NJ 07040
(888) 287-3652
(973) 549-6079
Mailing address
P.O. BOX 785361, PEDIATRIC SURGERY GROUP, PHILADELPHIA, PA 19178
(888) 287-3652
(973) 549-6079
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
25MA0669860
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7558406
—
NJ
Enumeration date
06/03/2006
Last updated
12/21/2010
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