Provider Demographics
NPI:1245940311
Name:PENDSE, NIKITA GIRISH (PA-C)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:GIRISH
Last Name:PENDSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SLATER CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1712
Mailing Address - Country:US
Mailing Address - Phone:908-635-2483
Mailing Address - Fax:
Practice Address - Street 1:7 SLATER CT
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1712
Practice Address - Country:US
Practice Address - Phone:908-635-2483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant