Provider Demographics
NPI:1922405604
Name:MANJI, NAILA (DDS)
Entity Type:Individual
Prefix:
First Name:NAILA
Middle Name:
Last Name:MANJI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E 46TH ST RM 1300
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-9245
Mailing Address - Country:US
Mailing Address - Phone:917-566-6002
Mailing Address - Fax:
Practice Address - Street 1:20 E 46TH ST RM 1300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-9245
Practice Address - Country:US
Practice Address - Phone:917-566-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist