Provider Demographics
NPI:1962478776
Name:SAINI, MANISH SATYAPRAKASH (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:SATYAPRAKASH
Last Name:SAINI
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 1:1163 RTE 37 W
Mailing Address - Street 2:SUITE B1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4973
Mailing Address - Country:US
Mailing Address - Phone:732-341-7900
Mailing Address - Fax:732-341-4706
Practice Address - Street 1:1163 RTE 37 W
Practice Address - Street 2:SUITE B1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4973
Practice Address - Country:US
Practice Address - Phone:732-341-7900
Practice Address - Fax:732-341-4706
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07718000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0064581Medicaid
NJ0064581Medicaid
NJI 27864Medicare UPIN