Individual
GREGOR MANUKIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
111 S. 11TH STREET, BODINE CENTER G301, PHILADELPHIA, PA 19107-4824
(215) 955-5669
(215) 955-0412
Mailing address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-8067
(215) 955-0412
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD470505
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2015
Last updated
02/18/2021
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