Individual
DR. KISHORKUMAR P. MISTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
465 MOUNT PROSPECT AVE, NEWARK, NJ 07104-2907
(973) 483-3640
(973) 483-0132
Mailing address
36 PATTON DR, BLOOMFIELD, NJ 07003-5224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06775100
NJ
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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