Provider Demographics
NPI:1730279530
Name:MANN, RANON E (MD)
Entity Type:Individual
Prefix:
First Name:RANON
Middle Name:E
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:111 EAST 210TH STREET
Mailing Address - Street 2:DIVISION OF DERMATOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1246
Mailing Address - Country:US
Mailing Address - Phone:718-920-2680
Mailing Address - Fax:718-944-4219
Practice Address - Street 1:111 EAST 210TH STREET
Practice Address - Street 2:DIVISION OF DERMATOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1246
Practice Address - Country:US
Practice Address - Phone:718-920-2680
Practice Address - Fax:718-944-4219
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY204228207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology