Provider Demographics
NPI:1891529509
Name:DAMLE, MALVIKA JANKI (RN)
Entity type:Individual
Prefix:
First Name:MALVIKA
Middle Name:JANKI
Last Name:DAMLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CORSON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1617
Mailing Address - Country:US
Mailing Address - Phone:757-630-2748
Mailing Address - Fax:
Practice Address - Street 1:39 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1011
Practice Address - Country:US
Practice Address - Phone:800-360-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR26259600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse