Individual
MANISHA NIDAMARTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 ATLANTIC AVE, CAMDEN, NJ 08104-1132
(856) 246-3542
(856) 246-3528
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 246-3542
(856) 246-3528
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1366176398
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
1366176398
NJ
Other
Enumeration date
07/14/2022
Last updated
11/21/2022
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