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General NPI Number Information
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NPI Number | 1992174874
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Entity Type | Organization
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Legal Business Name | NISRIN Q. DAHODWALA MD PC
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 290 N WHITE HORSE PIKE
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City | HAMMONTON
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State | NJ
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Zip | 08037-1855
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Country | US
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Telephone | 609-567-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 290 N WHITE HORSE PIKE
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City | HAMMONTON
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State | NJ
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Zip | 08037-1855
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Country | US
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Telephone | 609-567-7882
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NISRIN Q. DAHODWALA
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Credential | MD
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Telephone | 609-567-7882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00576000
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License Number State | NJ
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