Provider Demographics
NPI:1376511105
Name:MANI, NERITAN
Entity Type:Individual
Prefix:DR
First Name:NERITAN
Middle Name:
Last Name:MANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4699
Mailing Address - Country:US
Mailing Address - Phone:914-681-1203
Mailing Address - Fax:914-681-2902
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4179
Practice Address - Country:US
Practice Address - Phone:914-734-3324
Practice Address - Fax:914-737-6304
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI40281Medicare UPIN
NY147SN1Medicare ID - Type Unspecified