Provider Demographics
NPI:1538318142
Name:CHANANA, MANJU (MD)
Entity Type:Individual
Prefix:DR
First Name:MANJU
Middle Name:
Last Name:CHANANA
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 1:148 PARSIPPANY RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4708
Mailing Address - Country:US
Mailing Address - Phone:973-884-3355
Mailing Address - Fax:973-884-3388
Practice Address - Street 1:10 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4367
Practice Address - Country:US
Practice Address - Phone:973-240-7825
Practice Address - Fax:973-884-3388
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08468300207R00000X
PAMD434897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine