Individual
MRS. MANHONG MA
Active
Individual
MRS. MANHONG MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA07969800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310557
—
NJ
01
—
105531
MEDICARE PTAN
NJ
01
—
1120360
AMERIGROUP
NJ
01
—
P5493786
OXFORD
—
Enumeration date
05/11/2006
Last updated
08/04/2021
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