Individual
DR. KETAN KANSAGRA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8600
(732) 249-9572
Mailing address
16 BROOKSIDE DR, PRINCETON, NJ 08540-8570
(732) 951-9692
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MA76166
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006670
—
NJ
Enumeration date
04/12/2006
Last updated
07/08/2007
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