Provider Demographics
NPI:1538592084
Name:GOWALI, NEHA M (MD)
Entity type:Individual
Prefix:DR
First Name:NEHA
Middle Name:M
Last Name:GOWALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUMMIT RADIOLOGICAL ASSOCIATES P.A.
Mailing Address - Street 2:1811 SPRINGFIELD AVENUE
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974
Mailing Address - Country:US
Mailing Address - Phone:908-277-3335
Mailing Address - Fax:908-376-1675
Practice Address - Street 1:333 CEDAR ST RM CB-30
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-785-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA102986002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program