Provider Demographics
NPI:1952383853
Name:MANCHEN, DENNIS RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RICHARD
Last Name:MANCHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1154
Mailing Address - Country:US
Mailing Address - Phone:908-782-5100
Mailing Address - Fax:908-782-0290
Practice Address - Street 1:6 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1154
Practice Address - Country:US
Practice Address - Phone:908-782-5100
Practice Address - Fax:908-782-0290
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28964174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
013023095OtherUNITED HEALTHCARE
NJ0615901Medicaid
NY5716493OtherGHI
37973894OtherMULTIPLAN
HUP047OtherOXFORD
NJ010028964NJ01OtherMEDICHOICE
411209OtherCIGNA
NJ010028964NJ01OtherANTHEM
5716493OtherQUALCARE
NJ60040267OtherHORIZON NJ DIRECT
PA0421977000OtherINDEPENDENCE BLUE CROSS
540109OtherFOCUS
5266948OtherCCN
PA599572OtherHIGHMARK
OK8055OtherHEALTHNET
4255564OtherAETNA
1325693OtherFIRST HEALTH
NY296851OtherEMPIRE
HUP047OtherOXFORD
4255564OtherAETNA