Provider Demographics
NPI:1912260902
Name:GOLWALA, NEHA GIRISH (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEHA
Middle Name:GIRISH
Last Name:GOLWALA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MYERS AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-2236
Mailing Address - Country:US
Mailing Address - Phone:201-288-4930
Mailing Address - Fax:
Practice Address - Street 1:1361 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2760
Practice Address - Country:US
Practice Address - Phone:732-381-8968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025280001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice