Individual
MANOJ MADHU SANGORAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(847) 971-6696
Mailing address
3450 WAYNE AVE, APT. 20G, BRONX, NY 10467-2510
(847) 971-6696
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A11181
CA
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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