Provider Demographics
NPI:1689860199
Name:BHALLA, MEENU G (MD)
Entity Type:Individual
Prefix:
First Name:MEENU
Middle Name:G
Last Name:BHALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-3464
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:1973 WASHINGTON VALLEY RD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08836-2053
Practice Address - Country:US
Practice Address - Phone:732-560-9225
Practice Address - Fax:732-560-8095
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09359100207R00000X
CAA72697174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine