Basic Information
Provider Information
NPI: 1811071210
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MANWANI
FirstName: SAVITA
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1650 SELWYN AVE APT 6D
Address2: BRONX LEBANON HOSPITAL CENTER, DEPT OF PEDIATRICS
City: BRONX
State: NY
PostalCode: 10457
CountryCode: US
TelephoneNumber: 7189601414
FaxNumber: 7185185124
Practice Location
Address1: BRONX LEBANON HOSPITAL CENTER
Address2: 1650 SELWYN AVE, APT 6D
City: BRONX
State: NY
PostalCode: 10458
CountryCode: US
TelephoneNumber: 7189601414
FaxNumber: 7185185124
Other Information
ProviderEnumerationDate: 10/24/2006
LastUpdateDate: 04/30/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X224515NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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