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General NPI Number Information
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NPI Number | 1841451036
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Entity Type | Organization
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Legal Business Name | MOHAN P. DAS M.D. , P.A.
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 68 RIDGEDALE AVE
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2006
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Country | US
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Telephone | 973-377-5459
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Fax | 973-377-0010
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Provider Business Mailing Address
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Address Line | 68 RIDGEDALE AVE
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2006
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Country | US
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Telephone | 973-377-5459
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Fax | 973-377-0010
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAN P DAS
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Credential | M.D.
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Telephone | 973-377-5459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA03034400
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License Number State | NJ
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