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Individual

NALINI BETHALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
466 OLD HOOK RD, SUITE 9, EMERSON, NJ 07630-1396
(201) 261-1005
(201) 261-4208
Mailing address
466 OLD HOOK RD, SUITE 9, EMERSON, NJ 07630-1396
(201) 261-1005
(201) 261-4208

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA04661000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
457024M5Y
MEDICARE ID
NJ
05
8127603
NJ
Enumeration date
04/07/2006
Last updated
01/06/2016
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