Provider Demographics
NPI:1992326342
Name:GODIN, NILUFAR (DO)
Entity type:Individual
Prefix:DR
First Name:NILUFAR
Middle Name:
Last Name:GODIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NILUFAR
Other - Middle Name:
Other - Last Name:ERNAZAROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1865 MARLTON PIKE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2005
Mailing Address - Country:US
Mailing Address - Phone:800-789-7366
Mailing Address - Fax:
Practice Address - Street 1:1865 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2005
Practice Address - Country:US
Practice Address - Phone:800-789-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11920900207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine