Provider Demographics
NPI:1235478033
Name:FIRDU, TIKIKIL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:TIKIKIL
Middle Name:
Last Name:FIRDU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:TIKIKIL
Other - Middle Name:FIRDU
Other - Last Name:BETRU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 BENJAMIN CT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3307
Mailing Address - Country:US
Mailing Address - Phone:609-317-5174
Mailing Address - Fax:
Practice Address - Street 1:123 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 214
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-896-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09448900207V00000X
NJP11-00462207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology