Healthcare Provider Details

I. General information

NPI: 1144431362
Provider Name (Legal Business Name): GEORGE MANIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 THIRD AVENUE ST BARNABAS HOSPITAL
BRONX NY
10457-2545
US

IV. Provider business mailing address

1401 NORWOOD WAY PO BOX 232
WHIPPANY NJ
07981-1435
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-3730
  • Fax:
Mailing address:
  • Phone: 973-952-1012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA08210100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number242398-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number242398
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: