Basic Information
| Provider Information | |||||||||
| NPI: | 1225174303 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | MANISH | ||||||||
| MiddleName: | RAVIN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSPT, PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 314 MARSHALL AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207074823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014982212 | ||||||||
| FaxNumber: | 3014982213 | ||||||||
| Practice Location | |||||||||
| Address1: | 730 FREDERICK RD | ||||||||
| Address2: | SUITE #202 | ||||||||
| City: | CATONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107198661 | ||||||||
| FaxNumber: | 4107198996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 04/09/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 21170 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.