Individual
MEENAKUMARI MANOHARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 OSTRUM ST, FOUNTAIN HILL, PA 18015-1000
(484) 526-7035
(484) 526-7040
Mailing address
801 OSTRUM ST, FOUNTAIN HILL, PA 18015-1000
(484) 526-7035
(484) 526-7040
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MT219074
PA
208D00000X
General Practice Physician
87682
GA
Other
Enumeration date
06/19/2019
Last updated
05/05/2021
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