Provider Demographics
NPI:1255564969
Name:SAWHNEY, MANITA (DO)
Entity type:Individual
Prefix:
First Name:MANITA
Middle Name:
Last Name:SAWHNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HUDSON VISTA MEDICAL, PC
Mailing Address - Street 2:19 LAUREL AVENUE
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518
Mailing Address - Country:US
Mailing Address - Phone:845-458-4853
Mailing Address - Fax:845-458-4435
Practice Address - Street 1:HUDSON VISTA MEDICAL, PC
Practice Address - Street 2:21 LAUREL AVENUE, SUITE 280
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518
Practice Address - Country:US
Practice Address - Phone:845-534-7080
Practice Address - Fax:845-534-4171
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT012337207R00000X
NY265558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3469954Medicaid