Provider Demographics
NPI:1568504280
Name:BUSH, NAHNDI (MD)
Entity Type:Individual
Prefix:DR
First Name:NAHNDI
Middle Name:
Last Name:BUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:NAHNDI
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1016 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2327
Mailing Address - Country:US
Mailing Address - Phone:973-546-5700
Mailing Address - Fax:973-546-8898
Practice Address - Street 1:40 UNION AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3277
Practice Address - Country:US
Practice Address - Phone:973-399-6270
Practice Address - Fax:973-374-3346
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66285207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7498608Medicaid
NJG56027Medicare UPIN
NJ7498608Medicaid