Provider Demographics
NPI:1083105183
Name:GHATE, MANJARI
Entity Type:Individual
Prefix:
First Name:MANJARI
Middle Name:
Last Name:GHATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 EDDINGTON LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5332
Mailing Address - Country:US
Mailing Address - Phone:609-448-0347
Mailing Address - Fax:
Practice Address - Street 1:14 EDDINGTON LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-5332
Practice Address - Country:US
Practice Address - Phone:609-448-0347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00265600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist