Provider Demographics
NPI:1619339785
Name:MANHATTAN NEPHROLOGY AND CRITICAL CARE PLLC
Entity Type:Organization
Organization Name:MANHATTAN NEPHROLOGY AND CRITICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHANSHU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-862-5215
Mailing Address - Street 1:310 W 120TH ST
Mailing Address - Street 2:APT 3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6192
Mailing Address - Country:US
Mailing Address - Phone:917-862-5215
Mailing Address - Fax:718-347-4643
Practice Address - Street 1:116 E 124TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1933
Practice Address - Country:US
Practice Address - Phone:646-979-3316
Practice Address - Fax:646-979-3320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269730207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty