Individual
NIDHI KANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3831
Mailing address
120 LAMPLIGHTER CT, MARLTON, NJ 08053
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA773870
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA773870
STATE LICENSE
NJ
01
—
DO8536900
STNA
NJ
Enumeration date
10/23/2006
Last updated
07/08/2007
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