Basic Information
| Provider Information | |||||||||
| NPI: | 1952383853 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANCHEN | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 6 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088221154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087825100 | ||||||||
| FaxNumber: | 9087820290 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088221154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087825100 | ||||||||
| FaxNumber: | 9087820290 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2005 | ||||||||
| LastUpdateDate: | 09/15/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 28964 | NJ | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 013023095 | 01 | UNITED HEALTHCARE | OTHER | 0615901 | 05 | NJ | MEDICAID | 5716493 | 01 | NY | GHI | OTHER | 37973894 | 01 | MULTIPLAN | OTHER | HUP047 | 01 | OXFORD | OTHER | 010028964NJ01 | 01 | NJ | MEDICHOICE | OTHER | 411209 | 01 | CIGNA | OTHER | 010028964NJ01 | 01 | NJ | ANTHEM | OTHER | 5716493 | 01 | QUALCARE | OTHER | 60040267 | 01 | NJ | HORIZON NJ DIRECT | OTHER | 0421977000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 540109 | 01 | FOCUS | OTHER | 5266948 | 01 | CCN | OTHER | 599572 | 01 | PA | HIGHMARK | OTHER | OK8055 | 01 | HEALTHNET | OTHER | 4255564 | 01 | AETNA | OTHER | 1325693 | 01 | FIRST HEALTH | OTHER | 296851 | 01 | NY | EMPIRE | OTHER |