Provider Demographics
NPI:1104077650
Name:MANES, RICHARD PETER (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PETER
Last Name:MANES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:800 HOWARD AVE FL 4
Mailing Address - Street 2:YALE PHYSICIANS BUILDING
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-785-2593
Mailing Address - Fax:203-785-3970
Practice Address - Street 1:800 HOWARD AVE FL 4
Practice Address - Street 2:YALE PHYSICIANS BUILDING
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-2593
Practice Address - Fax:203-785-3970
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN3160207Y00000X
CT048958207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology