Provider Demographics
NPI:1124286588
Name:KUMAR, NIDHI (MD)
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 WAKEFIELD LN
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5817
Mailing Address - Country:US
Mailing Address - Phone:917-968-8643
Mailing Address - Fax:
Practice Address - Street 1:75 BRUNSWICK WOODS DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5601
Practice Address - Country:US
Practice Address - Phone:732-254-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243944207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0287059Medicaid
NJ0287059Medicaid