Individual
DIVYA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 W MAIN ST, SUITE 205 CN5050, FREEHOLD, NJ 07728-2537
(732) 866-0800
(732) 463-6082
Mailing address
901 W MAIN ST, SUITE 205, FREEHOLD, NJ 07728-2537
(732) 866-0800
(732) 463-6082
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA08657500
NJ
207UN0901X
Nuclear Cardiology Physician
25MA08657500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321311
—
NJ
Enumeration date
01/27/2009
Last updated
03/13/2017
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