Healthcare Provider Details

I. General information

NPI: 1851966303
Provider Name (Legal Business Name): MANJULA KRISHNAMURTHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MERCY HEALTH BLVD
CINCINNATI OH
45211-1103
US

IV. Provider business mailing address

8 SENECA AVE
EMERSON NJ
07630-1225
US

V. Phone/Fax

Practice location:
  • Phone: 513-215-5000
  • Fax:
Mailing address:
  • Phone: 201-562-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.150376
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: