Provider Demographics
NPI:1851966303
Name:KRISHNAMURTHY, MANJULA (MD)
Entity type:Individual
Prefix:
First Name:MANJULA
Middle Name:
Last Name:KRISHNAMURTHY
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 1:8 SENECA AVE
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1225
Mailing Address - Country:US
Mailing Address - Phone:201-562-6230
Mailing Address - Fax:
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1103
Practice Address - Country:US
Practice Address - Phone:513-215-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.150376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine