Provider Demographics
NPI:1669577235
Name:MANHATTAN RADIOLOGY, LLP
Entity type:Organization
Organization Name:MANHATTAN RADIOLOGY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-539-7641
Mailing Address - Street 1:1133 COLLEGE AVENUE
Mailing Address - Street 2:C143
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2751
Mailing Address - Country:US
Mailing Address - Phone:785-539-7641
Mailing Address - Fax:785-537-7620
Practice Address - Street 1:1133 COLLEGE AVENUE
Practice Address - Street 2:C143
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2751
Practice Address - Country:US
Practice Address - Phone:785-539-7641
Practice Address - Fax:785-537-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSMULTIPLE PHYSICIANS173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100087780AMedicaid
KS100087780AMedicaid