Organization
MANASA HEALTH CENTER. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIDAGALLE GOWDA M.D (PHYSICIAN/OWNER)
(732) 230-2529
Entity
Organization
Contact information
Practice address
2 CAITLIN CT, PRINCETON, NJ 08540-9496
(732) 230-2529
(732) 274-2776
Mailing address
3084 STATE ROUTE 27 STE 7, KENDALL PARK, NJ 08824-1657
(732) 230-2529
(732) 274-2776
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA07869800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124729
—
NJ
Enumeration date
06/11/2015
Last updated
06/11/2015
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