Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25MA08465300 | NJ |
NPI | 1003869041 |
---|---|
Provider Name | Mr. Nikhil Deshpande |
First Address | Somers Point, NJ 08244-2172 |
Second Address | Somers Point, NJ 08244-2172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 01/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11256 | (05) | ND |
123168500 | (05) | MN |
H17071 | (02) |