Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101261766 | VA |
N | 2080P0205X | Pediatric Endocrinologist | 0101261766 | VA |
Y | 2080P0205X | Pediatric Endocrinologist | 25MA10504200 | NJ |
NPI | 1033493267 |
---|---|
Provider Name | Kanhere Mansi Mukund |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-7337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2011 |
Last Update Date | 04/02/2020 |