Provider Demographics
NPI:1629086616
Name:MANSON, AARON N (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:N
Last Name:MANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 FORT WASHINGTON AVE
Mailing Address - Street 2:STE 421
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-3804
Mailing Address - Fax:212-305-0713
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:STE 421
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-3804
Practice Address - Fax:212-305-0713
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C06793Medicare UPIN
NY21A722Medicare PIN