Prem Nandiwada MD PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

NJ57313 Issued in NJ

Legal business name

PREM NANDIWADA MD PC

Practice address

24 Plaza 9
Manalapan, NJ 07726-3010

Phone

(732) 625-0210

Fax

(732) 625-0214

NPI assigned

Mar 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prem Nandiwada, MD

Title

President

Phone

(732) 625-0210

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1013049600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PLAZA 9",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263010",
            "telephone_number": "732-625-0210",
            "fax_number": "732-625-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PLAZA 9",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263010",
            "telephone_number": "732-625-0210",
            "fax_number": "732-625-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREM NANDIWADA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "NANDIWADA",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-625-0210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA57313",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "NJ57313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6417205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaac David Ponte, NJ-LSW, NY-LMSW
• Linda Poranski
• Sophia Porcelli, OTR/L
• Kristy Postorino
• Anthony Pozsonyi
• Premier Care Dentistry LLC
• Premier Mental & Behavioral Services, Inc
• Prestige Medical & Anesthesiology Associates, PC
• Primewell Health Inc
• Irina Pritsker, BS.OTR/L

• Gastroenterology Physician in Manalapan, NJ
• Providers in Manalapan, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.