Basic Information
| Provider Information | |||||||||
| NPI: | 1326031501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KINLEY | ||||||||
| FirstName: | NANDITA | ||||||||
| MiddleName: | TANDON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16312 MOUNT AIRY RD | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173611623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172273800 | ||||||||
| FaxNumber: | 7172273802 | ||||||||
| Practice Location | |||||||||
| Address1: | 16312 MOUNT AIRY RD | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173611623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172273800 | ||||||||
| FaxNumber: | 7172273802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 02/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD423321 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.