Provider Demographics
NPI:1023504313
Name:NIJJAR, MANVIR
Entity type:Individual
Prefix:
First Name:MANVIR
Middle Name:
Last Name:NIJJAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HYACINTH DRIVE APT 3H
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863
Mailing Address - Country:US
Mailing Address - Phone:973-842-6985
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES STREET
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08818
Practice Address - Country:US
Practice Address - Phone:732-321-7487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program