Provider Demographics
NPI:1346882529
Name:VIRA, MANSI
Entity Type:Individual
Prefix:
First Name:MANSI
Middle Name:
Last Name:VIRA
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 1:728 S MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3724
Mailing Address - Country:US
Mailing Address - Phone:732-762-1294
Mailing Address - Fax:
Practice Address - Street 1:728 S MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-3724
Practice Address - Country:US
Practice Address - Phone:732-762-1294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath