Provider Demographics
NPI:1154671873
Name:ABDALGANI, MANAR MOHAMMAD SHARIF (MBBS)
Entity type:Individual
Prefix:
First Name:MANAR
Middle Name:MOHAMMAD SHARIF
Last Name:ABDALGANI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 W 168TH ST
Mailing Address - Street 2:PH 17-101
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3270
Mailing Address - Country:US
Mailing Address - Phone:612-406-9773
Mailing Address - Fax:
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN62130207K00000X
VA0116024852390200000X
NY319721207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program