Individual
DR. NIVETHIETHA MANIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2300 COMPUTER RD STE E25, WILLOW GROVE, PA 19090-1737
(215) 659-5480
(215) 659-5482
Mailing address
660 WHITE PLAINS RD STE 400, TARRYTOWN, NY 10591-5107
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD485126
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043943450001
—
PA
Enumeration date
04/11/2019
Last updated
03/05/2025
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