Provider Demographics
NPI:1013025337
Name:COASTAL NEPHROLOGY AND HYPERTENSION PC
Entity Type:Organization
Organization Name:COASTAL NEPHROLOGY AND HYPERTENSION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELIND
Authorized Official - Middle Name:R
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-463-2755
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1939
Practice Address - Country:US
Practice Address - Phone:609-463-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07515600207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDF7230OtherRAILROAD MEDICARE
NJ0116629Medicaid
NJ104000VRCMedicare PIN