Provider Demographics
NPI:1336136993
Name:DASGUPTA, MANASH K (MD)
Entity Type:Individual
Prefix:DR
First Name:MANASH
Middle Name:K
Last Name:DASGUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9A CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4746
Mailing Address - Country:US
Mailing Address - Phone:914-376-3330
Mailing Address - Fax:914-376-1566
Practice Address - Street 1:9A CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4746
Practice Address - Country:US
Practice Address - Phone:914-376-3330
Practice Address - Fax:914-376-1566
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW38281OtherMEDICARE GROUP PIN
NY445112311OtherUNITED HEALTH CARE
NYP412198OtherOXFORD
NY1000005074OtherAFFINITY HEALTH PLAN
NYCK6794OtherRAILROAD MEDICARE
NY00238615Medicaid
NY3300322OtherGHI
NY1000005074OtherAFFINITY HEALTH PLAN
NY310581Medicare PIN