Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25MB10225600 | NJ |
NPI | 1003200148 |
---|---|
Provider Name | Dr. Adil Manzoor |
First Address | Glen Allen, VA 23060-9263 |
Second Address | Tinton Falls, NJ 07724-2636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 02/03/2021 |