Provider Demographics
NPI:1598929218
Name:KULKARNI, NANDINI N (MD)
Entity type:Individual
Prefix:
First Name:NANDINI
Middle Name:N
Last Name:KULKARNI
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 1:1601 TILTON RD STE 4
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1858
Mailing Address - Country:US
Mailing Address - Phone:609-568-5606
Mailing Address - Fax:609-303-2482
Practice Address - Street 1:1601 TILTON RD STE 4
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1858
Practice Address - Country:US
Practice Address - Phone:609-568-5606
Practice Address - Fax:609-303-2482
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA097061002086X0206X
PAMT193982208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0476552Medicaid
NJ431027YTJSMedicare PIN