Provider Demographics
NPI:1417937913
Name:IYER, MANNY SUBRAMANIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MANNY
Middle Name:SUBRAMANIA
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-419-4600
Mailing Address - Fax:610-419-3386
Practice Address - Street 1:5325 NORTHGATE DRIVE,
Practice Address - Street 2:SUITE 202
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9413
Practice Address - Country:US
Practice Address - Phone:610-419-4600
Practice Address - Fax:610-419-3386
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD032650E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001391374Medicaid
0911121OtherUNITED HEALTHCARE
0562147000OtherINDEPENDENCE BLUE CROSS
724515OtherHIGHMARK BLUE SHIELD
821129OtherFIRST PRIORITY HEALTH
85218OtherGEISINGER HEALTH PLAN
2684983OtherCIGNA HEALTHCARE
4507427OtherAETNA PPO
0562147000OtherAMERIHEALTH
171898OtherPRIVATE HEALTHCARE SYSTEM
427544OtherHEALTH AMERICA/HEALTH ASS
50055595OtherCAPITAL BLUE CROSS
50055595OtherKEYSTONE HEALTH CENTRAL
P00285844OtherRAILROAD MEDICARE
171898OtherPRIVATE HEALTHCARE SYSTEM
2684983OtherCIGNA HEALTHCARE
0562147000OtherINDEPENDENCE BLUE CROSS
821129OtherFIRST PRIORITY HEALTH
E81843Medicare UPIN