Individual
DR. MANISH PRAKASH PONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 YORK AVE, BOX 179, NEW YORK, NY 10065-6307
(917) 599-8477
Mailing address
504 E 63RD ST, APT 10P, NEW YORK, NY 10065-7912
(917) 599-8477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
229346
NY
207RN0300X
Nephrology Physician
Primary
229346
NY
Other
Enumeration date
01/10/2007
Last updated
11/22/2016
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