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General NPI Number Information
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NPI Number | 1265876833
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Entity Type | Individual
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Provider Name | MANINDER SINGH BHUTANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 450 CLARKSON AVE BOX 1262
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone | 718-270-8867
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Fax |
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Provider Business Mailing Address
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Address Line | 450 CLARKSON AVE BOX 1262
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD047518
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101267136
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A143230
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License Number State | CA
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