Individual
ERIC M MANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
285 SILLS RD BLDG 18, EAST PATCHOGUE, NY 11772-4808
(631) 475-1224
(631) 475-1588
Mailing address
285 SILLS RD BLDG 18, EAST PATCHOGUE, NY 11772-4808
(631) 475-1224
(631) 475-1588
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
228160
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
228160
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02861085
—
NY
01
—
844F61
BLUE SHIELD
NY
Enumeration date
09/16/2006
Last updated
08/15/2019
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