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Individual

DR. HARISH NANDIGAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5034
Mailing address
3996 FAIR RIDGE DR, SUITE 350, FAIRFAX, VA 22033-2961
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA08802900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0241971
NJ
Enumeration date
09/07/2008
Last updated
03/30/2015
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