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Individual
YOGITA MANTENA
Active
Individual
YOGITA MANTENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
228403-1
NY
207P00000X
Emergency Medicine Physician
Primary
Q6651
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02512765
—
NY
01
—
2556N1
BLUECROSS BLUESHIELD
NY
Enumeration date
12/29/2005
Last updated
02/15/2018
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