Individual
AMARA NIDIMUSILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 MADISON AVE, MOUNT HOLLY, NJ 08060-2099
(609) 914-6000
(609) 914-6182
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA09501000
NJ
208M00000X
Hospitalist Physician
Primary
25MA09501000
NJ
Other
Enumeration date
01/10/2014
Last updated
10/21/2020
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