Organization
SHETAL MANSURIA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHETAL M MANSURIA MD (PHYSICIAN/OWNER)
(973) 294-2212
Entity
Organization
Contact information
Practice address
22 OLD SHORT HILLS RD, SUITE 213, LIVINGSTON, NJ 07039-5604
(973) 535-3800
(973) 535-3808
Mailing address
PO BOX 2107, LIVINGSTON, NJ 07039-7707
(973) 535-3800
(973) 535-3808
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MA71413
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064937
MEDICARE, TYPE UNSPECIFIED
NJ
Enumeration date
06/26/2009
Last updated
06/26/2009
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