Individual
VIJAYA LAKSHMI GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
140 BERGEN ST, ACC LEVEL C, NEWARK, NJ 07103-2425
(973) 972-2700
(973) 972-2739
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
25MA02898900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1140809
—
NJ
Enumeration date
07/11/2006
Last updated
07/22/2009
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