MANISHA C BALWANI M.D., M.S., NPI 1548362759 — NEW YORK (NY)

NPI 1548362759

14+ Years Experience Individual

MANISHA C BALWANI M.D., M.S.

09.01.2006
PROVIDER ENUMERATION DATE
03/22/2019
LAST UPDATE DATE
1548362759
NPI NUMBER

About MANISHA C BALWANI

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MANISHA C BALWANI is a provider established in NEW YORK, NY. The NPI number of MANISHA C BALWANI is 1548362759 and was assigned on 09.01.2006. The practitioners primary taxonomy code is: 207SG0201X with license number: 2709 NY .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100296500
  • Phone: 2122410915
  • Fax: 2124269065
  • Address: ONE GUSTAVE L. LEVY PLACE
  • Address 2: BOX 1497, DEPARTMENT OF HUMAN GENETICS

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1548362759
  • Phone : 2122410915
  • Fax : 2124269065
  • Postalcode : 100296500
  • Address : 1184 FIFTH AVENUE 2ND FLOOR

Additional identifiers

  • Identifier: 2811205
  • Code / Type : 5 - MEDICAID
  • Identifier state : NY

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Medical Genetics

  • Taxonomy code: 207SG0201X
  • License number: 2709
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.

Contacts:

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  • MANISHA C BALWANI M.D., M.S.
  • Address : 1184 FIFTH AVENUE 2ND FLOOR
  • Region : NEW YORK, NY
  • NPI : 1548362759
  • Phone : 2122410915
  • Fax : 2124269065
  • Postalcode : 100296500

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1184 FIFTH AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address2ND FLOOR
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code100296500
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2122410915
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2124269065
The fax number associated with the location address of the provider being identified.
NPI1548362759
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207SG0201X
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
Provider Enumeration Date09.01.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated03/22/2019
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MANISHA C BALWANI
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressONE GUSTAVE L. LEVY PLACE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressBOX 1497, DEPARTMENT OF HUMAN GENETICS
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNEW YORK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code100296500
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2122410915
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2124269065
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1207SG0201X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Medical Genetics
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
Provider License Number 12709
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 12811205
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1NY
Other Provider Identifier State #1
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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