Individual
MANAVATTIRA B THIMMAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
492 STATE ROUTE 57 W, WASHINGTON, NJ 07882-4338
(908) 689-1000
(908) 689-4529
Mailing address
10 GEOFFREY DRIVE, KINNELON, NJ 07405
(973) 492-0818
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA03490300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0789500
—
NJ
Enumeration date
11/08/2006
Last updated
09/04/2012
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