Healthcare Provider Details

I. General information

NPI: 1144422668
Provider Name (Legal Business Name): MONISHA H VORA R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 JARMAN PL
BRIDGEWATER NJ
08807
US

IV. Provider business mailing address

31 JARMAN PL
BRIDGEWATER NJ
08807-5580
US

V. Phone/Fax

Practice location:
  • Phone: 732-545-2880
  • Fax:
Mailing address:
  • Phone: 732-545-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number858810
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: