Provider Demographics
NPI:1831238823
Name:MANUEL, SANGEETA (MD)
Entity type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:MANUEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-8500
Mailing Address - Country:US
Mailing Address - Phone:602-586-8682
Mailing Address - Fax:
Practice Address - Street 1:7157 MARY PECK BOND PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1236
Practice Address - Country:US
Practice Address - Phone:412-661-2802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD476181208000000X
AZ42228208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ440168Medicaid