Provider Demographics
NPI:1740607969
Name:PANNEERSELVAM, NARMADHA
Entity type:Individual
Prefix:
First Name:NARMADHA
Middle Name:
Last Name:PANNEERSELVAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STATE ROUTE 31 RM 116
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5752
Mailing Address - Country:US
Mailing Address - Phone:082-841-1125
Mailing Address - Fax:908-284-2016
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-237-5486
Practice Address - Fax:908-237-5488
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10173100207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine