Provider Demographics
NPI:1831651082
Name:NAND GHANSHYAM
Entity Type:Organization
Organization Name:NAND GHANSHYAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SRUTIVALLABHDAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-489-8092
Mailing Address - Street 1:347 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:347 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1123
Practice Address - Country:US
Practice Address - Phone:972-489-8092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care