Provider Demographics
NPI:1962830083
Name:MANIAR PEDIATRICS
Entity Type:Organization
Organization Name:MANIAR PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-676-2492
Mailing Address - Street 1:90 WASHINGTON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1050
Mailing Address - Country:US
Mailing Address - Phone:973-676-2492
Mailing Address - Fax:
Practice Address - Street 1:90 WASHINGTON ST
Practice Address - Street 2:SUITE 305
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1050
Practice Address - Country:US
Practice Address - Phone:973-676-2492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0210218Medicaid