Individual
MS. MANISHA PANWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
18 ENGLE ST APT 6U, TENAFLY, NJ 07670-2826
(917) 415-0504
Mailing address
18 ENGLE ST APT 6U, TENAFLY, NJ 07670-2826
(917) 415-0504
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
933723
NJ
133VN1006X
Metabolic Nutrition Registered Dietitian
933723
NJ
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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