Individual
AJITHA NINAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
73 COLUMBIA AVE, NUTLEY, NJ 07110-2503
(973) 542-0034
Mailing address
73 COLUMBIA AVENUE, NUTLEY, NJ 07110-2503
(973) 542-0034
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00021500
NJ
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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