Provider Demographics
NPI:1164712626
Name:SADHALE, MANASI MAYURESH (DPM)
Entity Type:Individual
Prefix:MRS
First Name:MANASI
Middle Name:MAYURESH
Last Name:SADHALE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MANASI
Other - Middle Name:AMIT
Other - Last Name:MEGHPARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1755 WYNDALE ST APT 438
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4152
Mailing Address - Country:US
Mailing Address - Phone:630-299-9626
Mailing Address - Fax:
Practice Address - Street 1:990 AVENUE OF THE AMERICAS APT 24B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5431
Practice Address - Country:US
Practice Address - Phone:630-299-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006690213ES0103X
TXX045213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery