Provider Demographics
NPI:1396772299
Name:SRICHAI, MANAKAN B (MD)
Entity type:Individual
Prefix:DR
First Name:MANAKAN
Middle Name:B
Last Name:SRICHAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7 CEDAR GROVE LN
Mailing Address - Street 2:SUITE 31
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1331
Mailing Address - Country:US
Mailing Address - Phone:732-873-1400
Mailing Address - Fax:732-960-3444
Practice Address - Street 1:7 CEDAR GROVE LN
Practice Address - Street 2:SUITE 31
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1331
Practice Address - Country:US
Practice Address - Phone:732-873-1400
Practice Address - Fax:732-960-3444
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08736200207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology