Individual
MANASA AYYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 BERGEN ST # H-245, NEWARK, NJ 07103-2496
(973) 972-5672
Mailing address
150 BERGEN ST # H-245, NEWARK, NJ 07103-2496
(973) 972-5672
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0079369
MD
Other
Enumeration date
05/23/2012
Last updated
02/22/2022
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