Provider Demographics
NPI:1417145541
Name:NANDINI MORAY MD PA
Entity Type:Organization
Organization Name:NANDINI MORAY MD PA
Other - Org Name:NANDINI MORAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDINI
Authorized Official - Middle Name:K
Authorized Official - Last Name:MORAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-546-7070
Mailing Address - Street 1:37 PROGRESS ST
Mailing Address - Street 2:SUITE AA5
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1179
Mailing Address - Country:US
Mailing Address - Phone:908-546-7070
Mailing Address - Fax:908-546-7069
Practice Address - Street 1:37 PROGRESS ST
Practice Address - Street 2:SUITE AA5
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-546-7070
Practice Address - Fax:908-546-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68737273Y00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7961901Medicaid
NJG99356Medicare UPIN
NJ086487Medicare PIN