Healthcare Provider Details

I. General information

NPI: 1346307386
Provider Name (Legal Business Name): MANIJEH SADJADI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GRAND CONCOURSE BRONX LEBANON HOSPITAL CENTER DEPT OF PATHOLOGY
BRONX NY
10457
US

IV. Provider business mailing address

201 EAST 79TH STREET APT 4C
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 718-518-5152
  • Fax: 718-716-8242
Mailing address:
  • Phone: 212-517-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number146815-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number25MA04009600
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberA37214
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number146815-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number25MA04009600
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA37214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: