Provider Demographics
NPI:1649952268
Name:MANHATTAN NEPHROLOGY PLLC
Entity type:Organization
Organization Name:MANHATTAN NEPHROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-265-8755
Mailing Address - Street 1:PO BOX 1375
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-0877
Mailing Address - Country:US
Mailing Address - Phone:650-265-8755
Mailing Address - Fax:540-235-5678
Practice Address - Street 1:21215 UNION TPKE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364-3519
Practice Address - Country:US
Practice Address - Phone:718-217-8600
Practice Address - Fax:540-235-5678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty