Healthcare Provider Details

I. General information

NPI: 1073768685
Provider Name (Legal Business Name): MANISH VERMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NEW SCOTLAND AVENUE CAPITAL DISTRICT PSYCHIATRIC CENTER
ALBANY NY
12209
US

IV. Provider business mailing address

75 NEW SCOTLAND AVENUE CAPITAL DISTRICT PSYCHIATRIC CENTER
ALBANY NY
12209
US

V. Phone/Fax

Practice location:
  • Phone: 518-549-6000
  • Fax: 718-334-5034
Mailing address:
  • Phone: 518-549-6000
  • Fax: 718-334-5034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number003250
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number271917
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: