Healthcare Provider Details

I. General information

NPI: 1972995298
Provider Name (Legal Business Name): NUTAN NADKARNI MD FAAP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

468 AMBOY AVE
PERTH AMBOY NJ
08861-3143
US

IV. Provider business mailing address

468 AMBOY AVE
PERTH AMBOY NJ
08861-3143
US

V. Phone/Fax

Practice location:
  • Phone: 732-442-1820
  • Fax: 732-442-2918
Mailing address:
  • Phone: 732-442-1820
  • Fax: 732-442-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NUTAN S NADKARNI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-512-9130