Individual
HARSHITHA MANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1305 YORK AVE FL 9, NEW YORK, NY 10021-5663
(646) 962-3376
Mailing address
1305 YORK AVE FL 9, NEW YORK, NY 10021-5663
(646) 962-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
316893
NY
390200000X
Student in an Organized Health Care Education/Training Program
11019907A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2015
Last updated
09/12/2022
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