Provider Demographics
NPI:1629338264
Name:DAS, NANDINI (MSC)
Entity Type:Individual
Prefix:MRS
First Name:NANDINI
Middle Name:
Last Name:DAS
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 J F KENNEDY BOULEVARD
Mailing Address - Street 2:304
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5780
Mailing Address - Country:US
Mailing Address - Phone:201-687-8883
Mailing Address - Fax:
Practice Address - Street 1:2700 J F KENNEDY BOULEVARD
Practice Address - Street 2:304
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5780
Practice Address - Country:US
Practice Address - Phone:201-687-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor