Provider Demographics
NPI:1407607724
Name:SANTHOSH, NITHYA (DO)
Entity Type:Individual
Prefix:
First Name:NITHYA
Middle Name:
Last Name:SANTHOSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4614
Mailing Address - Country:US
Mailing Address - Phone:908-812-6942
Mailing Address - Fax:
Practice Address - Street 1:6401 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1427
Practice Address - Country:US
Practice Address - Phone:954-776-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program