Provider Demographics
NPI:1598785883
Name:MANN, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 ALBANY STREET
Mailing Address - Street 2:TOWER 2, 7TH FLOOR
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2126
Mailing Address - Country:US
Mailing Address - Phone:732-937-8537
Mailing Address - Fax:732-937-8941
Practice Address - Street 1:10 PLUM STREET
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-235-8695
Practice Address - Fax:732-235-8696
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA47254207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0961205Medicaid
NJ0961205Medicaid
NJ404214B0FMedicare PIN
NJE56150Medicare UPIN