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Individual

DR. ANISH GEORGE MAMMEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
310 E 24TH ST, APT 1L, NEW YORK, NY 10010-4012
(617) 513-9508
Mailing address
4760 UNION DEPOSIT RD, STE 100, HARRISBURG, PA 17111-3744
(717) 545-5099
(717) 545-9979

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD472422
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/08/2008
Last updated
12/09/2020
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