Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 036.121021 | IL |
N | 204F00000X | Transplant Surgeon | 055397 | CT |
N | 204F00000X | Transplant Surgeon | 14248 | NV |
N | 208200000X | Surgeon | 036.121021 | IL |
N | 208600000X | Surgeon | 036.121021 | IL |
N | 208200000X | Surgeon | 055397 | CT |
N | 208600000X | Surgeon | 055397 | CT |
Y | 208200000X | Surgeon | 283546 | MA |
Y | 208600000X | Surgeon | 283546 | MA |
N | 2086S0129X | Vascular Surgeon | 14248 | NV |
NPI | 1326377284 |
---|---|
Provider Name | Dr. Bejon Temus Maneckshana |
First Address | Ludlow, MA 01056-0366 |
Second Address | West Springfield, MA 01089-1353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2009 |
Last Update Date | 12/10/2020 |