Provider Demographics
NPI:1225145360
Name:MCINTOSH, NENITA PARRILLA (MD)
Entity Type:Individual
Prefix:DR
First Name:NENITA
Middle Name:PARRILLA
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NENITA
Other - Middle Name:CORTES
Other - Last Name:PARRILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 CAPITAL WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-303-0747
Mailing Address - Fax:609-303-0771
Practice Address - Street 1:TWO CAPITAL WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-303-0747
Practice Address - Fax:609-303-0771
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04390600207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0144703Medicaid
NJD18772Medicare UPIN
NJ0144703Medicaid