Provider Demographics
NPI:1467466813
Name:RADCLIFF, NINA D (MD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:D
Last Name:RADCLIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:SINGH
Other - Last Name:RADCLIFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:65 W JIMMIE LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240-9102
Mailing Address - Country:US
Mailing Address - Phone:609-748-7597
Mailing Address - Fax:609-748-7586
Practice Address - Street 1:65 W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240-9102
Practice Address - Country:US
Practice Address - Phone:609-748-7597
Practice Address - Fax:609-748-7586
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08807000207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191720504OtherCSHCN
TX8AG301OtherBLUE CROSS BLUE SHIELD
TX8S3668OtherBLUE CROSS PROVIDER ID
TXP00355367OtherRR MEDICARE
TXP00355367OtherRR MEDICARE