Provider Demographics
NPI:1083711345
Name:DADHANIA, MANISH S (MD)
Entity type:Individual
Prefix:DR
First Name:MANISH
Middle Name:S
Last Name:DADHANIA
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 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ RM 311
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA71610207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
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NJ3207225OtherAETNA US HEALTHCARE
NJP00012270OtherRAILROAD MEDICARE
NJ10916367OtherCAQH
NJ39923OtherUNIVERSITY HEALTH PLAN
NJ010005262OtherAMERICHOICE
NJ1174641OtherHORIZON- NJ HEALTH
NJ1539932OtherAMERIHEALTH PPO PABS
NJ3553751OtherCIGNA
NJ9102507Medicaid
NJ3207225OtherAETNA US HEALTHCARE
NJ9102507Medicaid
NJ1174641OtherHORIZON- NJ HEALTH