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General NPI Number Information
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NPI Number | 1225064942
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Entity Type | Organization
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Legal Business Name | CONSULTANTS IN KIDNEY DISEASES PA
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 2333 WHITEHORSE MERCERVILLE RD STE 4
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City | MERCERVILLE
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-890-9111
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Fax | 609-890-6865
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Provider Business Mailing Address
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Address Line | 2333 WHITEHORSE MERCERVILLE RD STE 4
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City | MERCERVILLE
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-890-9111
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Fax | 609-890-6865
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ZAKARIA W MANIYA
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Credential | MD
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Telephone | 609-890-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA48702
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MA48702
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License Number State | NJ
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