Provider Demographics
NPI:1831464882
Name:YVES MANIGAT MD PA
Entity Type:Organization
Organization Name:YVES MANIGAT MD PA
Other - Org Name:ECHELON BARIATRIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YVES
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MANIGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-8445
Mailing Address - Street 1:600 SOMERDALE RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1858
Mailing Address - Country:US
Mailing Address - Phone:856-429-8445
Mailing Address - Fax:856-429-1962
Practice Address - Street 1:600 SOMERDALE RD
Practice Address - Street 2:SUITE 209
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1858
Practice Address - Country:US
Practice Address - Phone:856-429-8445
Practice Address - Fax:856-429-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02777100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0034916OtherAETNA
0634984-002OtherCIGNA
NJ3034402Medicaid
0072084000OtherAMERIHEALTH
47632OtherHORIZON NJ HEALTH
NJ3034402Medicaid
024635Medicare PIN