Individual
MANISHA C BALWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.
Contact information
Practice address
1184 FIFTH AVENUE, 2ND FLOOR, NEW YORK, NY 10029-6500
(212) 241-0915
(212) 426-9065
Mailing address
ONE GUSTAVE L. LEVY PLACE, BOX 1497, DEPARTMENT OF HUMAN GENETICS, NEW YORK, NY 10029-6500
(212) 241-0915
(212) 426-9065
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
002709
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02811205
—
NY
Enumeration date
09/01/2006
Last updated
03/22/2019
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