Individual
MANITHA HEGDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
60 LIPTON LN, WILLISTON PARK, NY 11596-1029
(347) 209-6566
Mailing address
60 LIPTON LN, WILLISTON PARK, NY 11596-1029
(347) 209-6566
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
016978
NY
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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