Individual
DR. MANAGE NISSANKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
127 ROSEMARY LN, SOUTH WINDSOR, CT 06074-1563
(860) 916-2578
Mailing address
127 ROSEMARY LN, SOUTH WINDSOR, CT 06074-1563
(860) 916-2578
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
016539
CT
2084P0800X
Psychiatry Physician
Primary
ME135031
FL
Other
Enumeration date
11/15/2005
Last updated
08/06/2020
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