Provider Demographics
NPI:1487892626
Name:JAIN, MANISHA (MD)
Entity type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:
Last Name:JAIN
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 1:343 CENTRAL PARK AVE APT C
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1360
Mailing Address - Country:US
Mailing Address - Phone:914-713-4544
Mailing Address - Fax:914-997-6128
Practice Address - Street 1:234 E 149TH ST # 5-18
Practice Address - Street 2:LINCOLN HOSPITAL, DEPARTMENT OF OBGYN
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250474207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology