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General NPI Number Information
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NPI Number | 1144487661
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Entity Type | Individual
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Provider Name | ELIZABETH M MANEJIAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 635 MADISON AVENUE 5TH FLOOR INTEGRATIVE CARE CENTER
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City | NY
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State | NY
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Zip | 10022-1009
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Country | US
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Telephone | 212-224-7927
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Fax | 212-224-7956
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Provider Business Mailing Address
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Address Line | 635 MADISON AVENUE 5TH FLOOR INTEGRATIVE CARE CENTER
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City | NY
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State | NY
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Zip | 10022-1009
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Country | US
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Telephone | 212-224-7927
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Fax | 212-224-7956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 238330
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License Number State | NY
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