Provider Demographics
NPI:1609086099
Name:LOUIS R. MANARA D.O.
Entity Type:Organization
Organization Name:LOUIS R. MANARA D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MANARA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-767-0009
Mailing Address - Street 1:200A ROUTE 73N
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9542
Mailing Address - Country:US
Mailing Address - Phone:856-767-0009
Mailing Address - Fax:856-767-0990
Practice Address - Street 1:200A ROUTE 73N
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9542
Practice Address - Country:US
Practice Address - Phone:856-767-0009
Practice Address - Fax:856-767-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB033420207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC52404Medicare UPIN
NJ004214Medicare ID - Type Unspecified