Individual
MANJU CHANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
173 MINEOLA BLVD STE 101, MINEOLA, NY 11501-2529
(516) 663-9494
Mailing address
173 MINEOLA BLVD STE 101, MINEOLA, NY 11501-2529
(516) 663-9494
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
119056
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00630828
—
NY
Enumeration date
11/28/2006
Last updated
03/03/2021
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