Provider Demographics
NPI:1477643211
Name:MANIGAT, YVES J (MD)
Entity Type:Individual
Prefix:
First Name:YVES
Middle Name:J
Last Name:MANIGAT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 SOMERDALE RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1858
Mailing Address - Country:US
Mailing Address - Phone:856-429-8445
Mailing Address - Fax:856-429-1962
Practice Address - Street 1:600 SOMERDALE RD
Practice Address - Street 2:SUITE 209
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1858
Practice Address - Country:US
Practice Address - Phone:856-429-8445
Practice Address - Fax:856-429-1962
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02777100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53945Medicare UPIN