Provider Demographics
NPI:1336311927
Name:GROVER, MANISHA B (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:B
Last Name:GROVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MANISHA
Other - Middle Name:
Other - Last Name:BATRA GROVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-2659
Mailing Address - Fax:973-322-2281
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-2659
Practice Address - Fax:973-322-2281
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08353100207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1843025OtherAETNA HMO
NJ0241717Medicaid
NY03039338Medicaid
NY6C7308OtherHEALTHNET
NY9025138OtherAETNA PPO
NJ3800171000OtherAMERIHEALTH
NY0412209OtherGHI PPO
NY000000130758OtherGHI HMO
NY247359OtherHIP
NY081030000089OtherFIDELIS
NY463SA1OtherEMPIRE BCBS OF NY
NY3229935791Medicare PIN
NY081030000089OtherFIDELIS