Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 77850 | GA |
N | 2080P0216X | Pediatric Rheumatologist | MT205493 | PA |
NPI | 1609168483 |
---|---|
Provider Name | Dr. Cynthia Kaiser Manos |
First Address | Atlanta, GA 30329-2309 |
Second Address | Atlanta, GA 30329-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2011 |
Last Update Date | 03/08/2021 |