Provider Demographics
NPI:1700173895
Name:PILLAI, NISHITHA RADHAKRISHNA (MD)
Entity type:Individual
Prefix:DR
First Name:NISHITHA
Middle Name:RADHAKRISHNA
Last Name:PILLAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 24TH AVE S STE 505
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1438
Mailing Address - Country:US
Mailing Address - Phone:612-273-0691
Mailing Address - Fax:612-273-0886
Practice Address - Street 1:606 24TH AVE S STE 505
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1438
Practice Address - Country:US
Practice Address - Phone:612-273-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116023337208000000X
MN67525207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics