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General NPI Number Information
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NPI Number | 1144580267
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Entity Type | Organization
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Legal Business Name | MANJU MISRA MD PC
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 1553 STATE ROUTE 27 SUITE 2500
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City | SOMERSET
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State | NJ
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Zip | 08873-3980
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Country | US
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Telephone | 732-296-9717
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Fax | 732-296-9711
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Provider Business Mailing Address
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Address Line | 1553 STATE ROUTE 27 SUITE 2500
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City | SOMERSET
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State | NJ
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Zip | 08873-3980
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Country | US
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Telephone | 732-296-9717
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Fax | 732-296-9711
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MANJU MISRA
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Credential | M.D.
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Telephone | 732-296-9717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 25MA05267300
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License Number State | NJ
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