Healthcare Provider Details

I. General information

NPI: 1306072665
Provider Name (Legal Business Name): NITTAL KALUSING LODHA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BUTTONWOOD CT
MOORESTOWN NJ
08057-1468
US

IV. Provider business mailing address

5 BUTTONWOOD CT
MOORESTOWN NJ
08057-1468
US

V. Phone/Fax

Practice location:
  • Phone: 718-702-2945
  • Fax: 856-432-4720
Mailing address:
  • Phone: 718-702-2945
  • Fax: 856-432-4720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03035700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP439666
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16823
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: