Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 0000 | NY |
N | 213EP1101X | Primary Podiatric Medicine | 0000 | PA |
NPI | 1154818979 |
---|---|
Provider Name | Dr. Vani Manchanda |
First Address | Natick, MA 01760-4171 |
Second Address | New York, NY 10010-5011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 12/11/2021 |