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General NPI Number Information
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NPI Number | 1861552671
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Entity Type | Individual
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Provider Name | MANJU MISRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1553 STATE ROUTE 27 STE 2500
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City | SOMERSET
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State | NJ
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Zip | 08873-3982
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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 # 2500
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City | SOMERSET
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State | NJ
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Zip | 08873
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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 |
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | MA52673
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License Number State | NJ
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