Individual
DR. SHITAL V MANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
(215) 276-1329
Mailing address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
(215) 276-1329
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002038
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0700258
—
MA
01
—
469930
TUFTS
MA
01
—
AA15576
HARVARD PILGRIM HEALTH CA
MA
01
—
W16395
BCBS
MA
Enumeration date
12/13/2005
Last updated
08/01/2008
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