Individual
NANIK R MANCHANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2457 E MAIN ST UNIT 105, WATERBURY, CT 06705-2685
(347) 475-2801
Mailing address
955 CONEY ISLAND AVE APT 101, BROOKLYN, NY 11230-1400
(347) 475-2801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28927
OK
208D00000X
General Practice Physician
Primary
051039
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013164854
—
CT
Enumeration date
08/23/2008
Last updated
06/25/2021
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