Dr. Shan M Nagendra, M.D.
Psychiatry & Neurology, Psychiatry in Clifton, NJ. Individual provider (NPI-1).
NPI number1164533659
StatusActive
Last updated in NPPESNov 11, 2020
Details
- NPI
- 1164533659
- Entity type
- Individual (NPI-1)
- Name
- Dr. Shan M Nagendra
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 31, 2006
- Certification date
- Nov 11, 2020
- Last updated
- Nov 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 142050 | NY | Yes |
| 174400000X | Specialist | 25MA03001300 | NJ |
Practice location
246 Barkley AveClifton, NJ 07011-3136
Phone 862-899-7531 · Fax 973-685-7370
Mailing address
246 Barkley AveClifton, NJ 07011-3136
Phone 862-899-7531 · Fax 973-685-7370
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