Provider Demographics
NPI:1275786931
Name:KAKU, MANJU B (MS)
Entity Type:Individual
Prefix:MRS
First Name:MANJU
Middle Name:B
Last Name:KAKU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MICHIGAN AVENUE, NW
Mailing Address - Street 2:CHIDREN'S NATIONAL MEDICAL CENTER
Mailing Address - City:WASHINGTON, DC
Mailing Address - State:DC
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:202-476-4013
Mailing Address - Fax:202-476-2613
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-4013
Practice Address - Fax:202-476-2163
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00593231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist