Provider Demographics
NPI:1740084086
Name:NISHU, MOSHAMMAT (DO)
Entity type:Individual
Prefix:DR
First Name:MOSHAMMAT
Middle Name:
Last Name:NISHU
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E LAUREL RD STE B
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1324
Mailing Address - Country:US
Mailing Address - Phone:856-633-6491
Mailing Address - Fax:
Practice Address - Street 1:101 E LAUREL RD STE B
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1324
Practice Address - Country:US
Practice Address - Phone:856-633-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program