Organization
PREM NANDIWADA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREM NANDIWADA MD (PRESIDENT)
(732) 625-0210
Entity
Organization
Contact information
Practice address
24 PLAZA 9, MANALAPAN, NJ 07726-3010
(732) 625-0210
(732) 625-0214
Mailing address
24 PLAZA 9, MANALAPAN, NJ 07726-3010
(732) 625-0210
(732) 625-0214
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
MA57313
NJ
207RG0100X
Gastroenterology Physician
Primary
NJ57313
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6417205
—
NJ
Enumeration date
03/10/2007
Last updated
05/04/2010
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