Provider Demographics
NPI:1639500358
Name:ANJALI GOVIL LLC
Entity Type:Organization
Organization Name:ANJALI GOVIL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJALI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOVIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-738-3032
Mailing Address - Street 1:1 KINCAID LN
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1273
Mailing Address - Country:US
Mailing Address - Phone:973-738-3032
Mailing Address - Fax:908-464-8092
Practice Address - Street 1:35 SOUTH ST
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1940
Practice Address - Country:US
Practice Address - Phone:973-738-3032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00614600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty