Manasa Health Center. LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA07869800 Issued in NJ

Legal business name

MANASA HEALTH CENTER. LLC

Practice address

2 Caitlin CT
Princeton, NJ 08540-9496

Phone

(732) 230-2529

Fax

(732) 274-2776

NPI assigned

Jun 11, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nidagalle Gowda, M.DNPI 1851346399

Title

Physician/Owner

Phone

(732) 230-2529

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nidagalle Gowda, MD

  • Pediatrics Physician
  • Kendall Park, NJ
  • NPI 1851346399
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1629459953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3084 STATE ROUTE 27 STE 7",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241657",
            "telephone_number": "732-230-2529",
            "fax_number": "732-274-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAITLIN CT",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085409496",
            "telephone_number": "732-230-2529",
            "fax_number": "732-274-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANASA HEALTH CENTER. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "GOWDA",
        "authorized_official_first_name": "NIDAGALLE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "732-230-2529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07869800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124729",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James J Maher III, LCSW, LCADC
• Deanna Renee Maiorino, RN
• Anna Mak, RPH
• Anuj Kumar Malhotra, M.D.
• Shamila Malik
• Bert Mandelbaum, M.D.
• Kathleen Manford, PHARMD
• Alexa R Mangan, FNP
• Sunita Mani, PT, DPT, MBA
• Eileen Mansfield, RN

• Psychiatry Physician in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.