Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 25MA11161900 | NJ |
N | 208800000X | Urologist | D86943 | MD |
NPI | 1063858595 |
---|---|
Provider Name | Dr. Nitin Kumar Yerram |
First Address | Neptune, NJ 07753-2645 |
Second Address | Hackensack, NJ 07601-8566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2013 |
Last Update Date | 27/09/2021 |