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General NPI Number Information
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NPI Number | 1396760609
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Entity Type | Individual
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Provider Name | MANISH VALLABHDAS BHALODIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 825 BLOOMFIELD AVE STE LL-1
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City | VERONA
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State | NJ
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Zip | 07044
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Country | US
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Telephone | 973-233-4493
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Fax | 833-484-1611
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Provider Business Mailing Address
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Address Line | 271 GROVE AVE STE E
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City | VERONA
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State | NJ
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Zip | 07044-1730
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Country | US
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Telephone | 973-559-3700
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Fax | 833-484-1686
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA06543200
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License Number State | NJ
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