Provider Demographics
NPI:1952497224
Name:NIKODIJEVIC, VESNA (MD)
Entity Type:Individual
Prefix:DR
First Name:VESNA
Middle Name:
Last Name:NIKODIJEVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MORRISTOWN RD STE 2D
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2310
Mailing Address - Country:US
Mailing Address - Phone:908-766-5960
Mailing Address - Fax:
Practice Address - Street 1:40 MORRISTOWN RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2310
Practice Address - Country:US
Practice Address - Phone:908-766-5960
Practice Address - Fax:866-768-8391
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07685300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics