Provider Demographics
NPI:1427074459
Name:NANAVATI, KAUSHAL KARTIKEY (MD)
Entity type:Individual
Prefix:DR
First Name:KAUSHAL
Middle Name:KARTIKEY
Last Name:NANAVATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 AGNES CT
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2300
Mailing Address - Country:US
Mailing Address - Phone:609-448-4600
Mailing Address - Fax:609-448-4660
Practice Address - Street 1:6 AGNES CT
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-2300
Practice Address - Country:US
Practice Address - Phone:609-448-4600
Practice Address - Fax:609-448-4660
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08019100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110362Medicare PIN
I72561Medicare UPIN