Individual
NAMALA LUKE MANOHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11- RALPH PLACE, STATEN ISLAND, NY 10304
(718) 815-1412
(718) 815-1413
Mailing address
267 EDINBORO ROAD, STATEN ISLAND, NY 10306-1204
(718) 815-1412
(718) 815-1413
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
129529
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001142254
—
NY
Enumeration date
03/31/2006
Last updated
02/09/2011
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