Provider Demographics
NPI:1194725200
Name:MANOR, EINAT (MD)
Entity type:Individual
Prefix:
First Name:EINAT
Middle Name:
Last Name:MANOR
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 1:465 SOUTH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6439
Mailing Address - Country:US
Mailing Address - Phone:973-971-7184
Mailing Address - Fax:973-290-8349
Practice Address - Street 1:465 SOUTH ST
Practice Address - Street 2:STE. 103
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6439
Practice Address - Country:US
Practice Address - Phone:973-971-7440
Practice Address - Fax:973-290-7520
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07718200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0039748Medicaid
I18462Medicare UPIN
NJ0039748Medicaid