Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 25MA07164000 | NJ |
N | 2080P0208X | Pediatric Infectious Diseases | MA71640 | NJ |
NPI | 1316007792 |
---|---|
Provider Name | Dr. Amisha Malhotra |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-1935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 23/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8390304 | (05) | NJ |
H29840 | (02) | NJ |