Individual
AWISHA BANSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 SEAVIEW DR, SECAUCUS, NJ 07094-1826
(201) 272-8852
Mailing address
30 SEAVIEW DR, SECAUCUS, NJ 07094-1826
(201) 272-8852
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00391100
NJ
Other
Enumeration date
02/18/2016
Last updated
07/21/2022
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