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General NPI Number Information
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NPI Number | 1205981230
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Entity Type | Individual
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Provider Name | MANISH GOPAL MD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 49 VERONICA AVE SUITE 207
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City | SOMERSET
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State | NJ
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Zip | 08873-6802
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Country | US
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Telephone | 877-987-6496
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Fax |
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Provider Business Mailing Address
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Address Line | 49 VERONICA AVE SUITE 207
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City | SOMERSET
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State | NJ
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Zip | 08873-6802
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Country | US
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Telephone | 877-987-6496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA08183500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | MA08183500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 25MA08183500
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License Number State | NJ
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