Provider Demographics
NPI:1225174303
Name:SINGH, MANISH RAVIN (MSPT, PT)
Entity Type:Individual
Prefix:MR
First Name:MANISH
Middle Name:RAVIN
Last Name:SINGH
Suffix:
Gender:M
Credentials:MSPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4823
Mailing Address - Country:US
Mailing Address - Phone:301-498-2212
Mailing Address - Fax:301-498-2213
Practice Address - Street 1:730 FREDERICK RD
Practice Address - Street 2:SUITE #202
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4532
Practice Address - Country:US
Practice Address - Phone:410-719-8661
Practice Address - Fax:410-719-8996
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist