Organization
MANIDVIPA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARIRAJAN MANI MD (CEO)
(423) 268-4100
Entity
Organization
Contact information
Practice address
158-01 CROSS BAY BLVD, HOWARD BEACH, NY 11414
(516) 260-6425
Mailing address
5 VALLEY BROOK CT, BLOOMINGTON, IL 61704-8385
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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