Provider Demographics
NPI:1144212598
Name:PANDYA, KIRITKUMAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRITKUMAR
Middle Name:M
Last Name:PANDYA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 PROSPECT ST
Mailing Address - Street 2:ST#101
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5020
Mailing Address - Country:US
Mailing Address - Phone:732-364-2262
Mailing Address - Fax:732-364-0711
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:ST#101
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5020
Practice Address - Country:US
Practice Address - Phone:732-364-2262
Practice Address - Fax:732-364-0711
Is Sole Proprietor?:No
Enumeration Date:2005-08-20
Last Update Date:2008-12-26
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Provider Licenses
StateLicense IDTaxonomies
NJ44527208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE13925Medicare UPIN