Provider Demographics
NPI:1497492722
Name:AISWARYA MENON, UNKNOWN
Entity Type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:AISWARYA MENON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FNU
Other - Middle Name:
Other - Last Name:AISWARYA MENON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:HACKEN SACK MERIDIAN HEALTH-PALISADES MEDICAL CENTER
Mailing Address - Street 2:7600 RIVER ROAD,
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047
Mailing Address - Country:US
Mailing Address - Phone:201-710-2762
Mailing Address - Fax:
Practice Address - Street 1:HACKEN SACK MERIDIAN HEALTH-PALISADES MEDICAL CENTER
Practice Address - Street 2:7600 RIVER ROAD,
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:201-710-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program