Provider Demographics
NPI:1093824732
Name:MISRA, NEERJA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERJA
Middle Name:
Last Name:MISRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 HIGHWAY 33 STE 518
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1750
Mailing Address - Country:US
Mailing Address - Phone:609-689-9001
Mailing Address - Fax:609-689-9002
Practice Address - Street 1:2279 HIGHWAY 33 STE 518
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1750
Practice Address - Country:US
Practice Address - Phone:609-689-9001
Practice Address - Fax:609-689-9002
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA59560207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6100503Medicaid
518433Medicare ID - Type Unspecified
NJ6100503Medicaid