Individual
DR. KAUSHIK SATYANARAYANA MANTHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
31 MAIN RD, SUITE 1, RIVERHEAD, NY 11901-1953
(631) 722-4400
(631) 722-4426
Mailing address
185 OLD COUNTRY RD, SUITE 2, RIVERHEAD, NY 11901-2121
(631) 298-4479
(631) 591-3047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
276389
NY
Other
Enumeration date
03/05/2013
Last updated
12/16/2014
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