Individual
DR. BHARATHI NAYAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
85 S HARRISON ST, SUITE # 101, EAST ORANGE, NJ 07018-1700
(973) 672-2005
(973) 672-2940
Mailing address
22 WINDING WAY, WOODLAND PARK, NJ 07424-2665
(973) 672-2005
(973) 672-2940
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
MA30135
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222499217
TAX ID
NJ
05
—
3160203
—
NJ
Enumeration date
09/27/2006
Last updated
12/19/2011
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