Provider Demographics
NPI:1316176084
Name:MORGANVILLE MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:MORGANVILLE MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMALATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-544-5551
Mailing Address - Street 1:119 AVENUE AT THE COMMONS
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4586
Mailing Address - Country:US
Mailing Address - Phone:732-544-5551
Mailing Address - Fax:732-544-5559
Practice Address - Street 1:119 AVENUE AT THE COMMONS
Practice Address - Street 2:SUITE 2
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4586
Practice Address - Country:US
Practice Address - Phone:732-544-5551
Practice Address - Fax:732-544-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty