Provider Demographics
NPI:1326224528
Name:CONTRACTOR, MANIJEH (MD)
Entity Type:Individual
Prefix:DR
First Name:MANIJEH
Middle Name:
Last Name:CONTRACTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2500 POND VW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:S SCHODACK
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9750
Mailing Address - Country:US
Mailing Address - Phone:518-477-2391
Mailing Address - Fax:518-477-2393
Practice Address - Street 1:3 ATRIUM DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1417
Practice Address - Country:US
Practice Address - Phone:518-438-5273
Practice Address - Fax:518-438-5398
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY247235207W00000X, 207WX0107X, 207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52833AOtherMEDICARE
NY52833AOtherMEDICARE
NYRB8072Medicare UPIN
J100000417Medicare PIN