Provider Demographics
NPI:1982640041
Name:ASTHANA, MANJUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MANJUL
Middle Name:
Last Name:ASTHANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MANJUL
Other - Middle Name:
Other - Last Name:SARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 JUPITER RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3426
Mailing Address - Country:US
Mailing Address - Phone:302-234-0214
Mailing Address - Fax:302-234-6617
Practice Address - Street 1:C/O HARMONIOUS MIND, 240 N. JAMES ST
Practice Address - Street 2:STE 111
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-0000
Practice Address - Country:US
Practice Address - Phone:302-407-1585
Practice Address - Fax:302-295-6289
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000113103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DER29292Medicare UPIN
DE490977Medicare ID - Type Unspecified