Provider Demographics
NPI:1598995342
Name:MOHAN, VEENA
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:
Last Name:MOHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NUGGEHALLI
Other - Middle Name:
Other - Last Name:VEENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 DARWIN BLVD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2343
Mailing Address - Country:US
Mailing Address - Phone:732-593-8060
Mailing Address - Fax:
Practice Address - Street 1:571 DARWIN BLVD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2343
Practice Address - Country:US
Practice Address - Phone:732-593-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS 00278100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist