Provider Demographics
NPI:1598872731
Name:VERMA, NITIN (MD,FACC)
Entity Type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:610-772-6889
Mailing Address - Fax:
Practice Address - Street 1:2630 HOLME AVE STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3004
Practice Address - Country:US
Practice Address - Phone:215-332-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435977207RC0000X, 207R00000X, 207RC0000X
NHLT4118207RC0000X
MEMD22458207RC0000X
NY296449207RC0000X
VA0101260788207RC0000X, 208M00000X
MDD66327207RC0000X
MO2014012496207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102467489Medicaid
MO1598872731Medicaid
PA1007278000OtherMEDICAID GROUP TPI
WI100086836Medicaid
PACD4829OtherRAILROAD MEDICARE TPI GROUP
PA037276OtherMLHC MEDICARE AA #
PA597586OtherMEDICARE GROUP TPI
PACD4829OtherRAILROAD MEDICARE TPI GROUP