Manickam Ganesh M.D., P.A.

LBN: Manickam Ganesh M.D., P.A.
Manickam Ganesh M.D., P.A. is an health care organization with primary practice located at 24 Park Ave , West Orange NJ 07052-5517. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Manickam Ganesh M.D., P.A. can be contacted via phone (973) 669-8181, or through Ganesh, Manickam via phone (973) 669-8181.

Contact Information

Primary practice address
24 Park Ave West Orange NJ 07052-5517
Fax: (973) 669-1687
Website:
Authorized official contact:
Name: Ganesh, Manickam Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA03057000 New Jersey
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 25MA03057000 New Jersey

Profile Details

NPI number 1831384486
LBN Legal business name Manickam Ganesh M.D., P.A.
DBA Doing business as
Authorized official Ganesh, Manickam Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 6th, 2007
Last updated Sep 6th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831384486 NPPES
New Jersey MEDICAID 2957604

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