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Individual

DR. PRATIK MANSUKH MAVANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
132 S 10TH ST, SUITE 1099J, PHILADELPHIA, PA 19107
(215) 955-6028
Mailing address
13 BEDFORD DR, MATAWAN, NJ 07747-6660
(973) 262-2764

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
293152
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/23/2012
Last updated
06/07/2018
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