Individual
MANOJ PUTHIYATHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 E RIDGEWOOD AVE, PARAMUS, NJ 07652-4142
(201) 967-4132
Mailing address
61 LINDEN ST, APT C9, HACKENSACK, NJ 07601-3534
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
25MA09523700
NJ
Other
Enumeration date
06/24/2009
Last updated
07/30/2015
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