Individual
MANJUSHREE MATADIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 277-8880
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 277-8880
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MB07597800
NJ
207R00000X
Internal Medicine Physician
25MB07597800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044377
—
NJ
Enumeration date
10/16/2006
Last updated
01/07/2020
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