| Ghanshyam Lalla & Pushpa Lalla Pc | |
|
383 Northfield Ave Suite 102 West Orange NJ 07052-3024 | |
| (973) 736-7750 | |
| (973) 669-9691 |
| Full Name | Ghanshyam Lalla & Pushpa Lalla Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 383 Northfield Ave, West Orange, New Jersey |
| Authorized Official Name and Position | Ghanshyam S Lalla (PRESIDENT) |
| Authorized Official Contact | 9737367750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ghanshyam Lalla & Pushpa Lalla Pc 383 Northfield Ave Suite 102 West Orange NJ 07052-3024 Ph: (973) 736-7750 | Ghanshyam Lalla & Pushpa Lalla Pc 383 Northfield Ave Suite 102 West Orange NJ 07052-3024 Ph: (973) 736-7750 |
| NPI Number | 1639381858 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 10/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639381858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26258 (New Jersey) | Primary |
| 207RH0000X | Internal Medicine - Hematology | 25819 (New Jersey) | Secondary |
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