Provider Demographics
NPI:1821232521
Name:DIN, NADIA (DPM)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:DIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 ROUTE 130
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1869
Mailing Address - Country:US
Mailing Address - Phone:856-393-8771
Mailing Address - Fax:856-393-8767
Practice Address - Street 1:8008 ROUTE 130
Practice Address - Street 2:SUITE 310
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1869
Practice Address - Country:US
Practice Address - Phone:856-393-8771
Practice Address - Fax:856-393-8767
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00300200213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
867337OtherMEDICARE GROUP
NJ0220744Medicaid