Provider Demographics
NPI:1033493267
Name:KANHERE, MANSI (MD)
Entity Type:Individual
Prefix:
First Name:MANSI
Middle Name:
Last Name:KANHERE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KANHERE
Other - Middle Name:
Other - Last Name:MANSI MUKUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:55 MADISON AVE FL 2
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7337
Practice Address - Country:US
Practice Address - Phone:973-971-4340
Practice Address - Fax:973-290-7367
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261766208000000X, 2080P0205X
NJ25MA105042002080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics