Individual
MANISHA KHATIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 345-4000
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
(440) 717-6600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA07978300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096181
—
NJ
01
—
2645115000
AMRRIHEALTH
NJ
01
—
30035356
KEYSTONE MERCY
NJ
01
—
60021304
HORIZON NJ HEALTH
NJ
Enumeration date
08/28/2006
Last updated
03/07/2023
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