Provider Demographics
NPI:1588048896
Name:MANAV LLC
Entity type:Organization
Organization Name:MANAV LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALIA
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICER
Authorized Official - Phone:732-754-5666
Mailing Address - Street 1:4 CROSSROADS DR STE 108
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3374
Mailing Address - Country:US
Mailing Address - Phone:732-754-5666
Mailing Address - Fax:
Practice Address - Street 1:4 CROSSROADS DR STE 108
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-3374
Practice Address - Country:US
Practice Address - Phone:732-754-5666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care