Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 043100 | CT |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 235305 | NY |
NPI | 1003860552 |
---|---|
Provider Name | Manisha Sakore |
First Address | Mineola, NY 11501-3808 |
Second Address | Mineola, NY 11501-3957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 29/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010043100CT101 | ANTHEM BC/BS (01) | CT |
043100 | CONNECTICARE (01) | CT |
1232083 | AETNA (01) | CT |
1297840 | CIGNA (01) | CT |
2V5138 | HEALTHNET (01) | CT |
H28904 | (02) | |
TIN | NORTHEAST HEALTH DIRECT (01) | CT |
TIN | POMCO (01) | CT |