# SHETAL MANSURIA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629206875
- **Authorized official:** DR. SHETAL M MANSURIA MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (973) 294-2212

## Contact information

- **Practice address:** 22 OLD SHORT HILLS RD, SUITE 213, LIVINGSTON, NJ 07039-5604
- **Practice address phone:** (973) 535-3800
- **Practice address fax:** (973) 535-3808
- **Mailing address:** PO BOX 2107, LIVINGSTON, NJ 07039-7707
- **Mailing address phone:** (973) 535-3800
- **Mailing address fax:** (973) 535-3808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | MA71413 | NJ | Yes |

## Other

- **Enumeration date:** 06/26/2009
- **Last updated:** 06/26/2009