Provider Demographics
NPI:1003363102
Name:NAIK, NIDHI
Entity Type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 US HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-9704
Mailing Address - Country:US
Mailing Address - Phone:974-584-7855
Mailing Address - Fax:
Practice Address - Street 1:1131 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852-9704
Practice Address - Country:US
Practice Address - Phone:974-584-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03805400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist