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General NPI Number Information
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NPI Number | 1518209139
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Entity Type | Organization
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Legal Business Name | REGIONAL RHEUMATOLOGY, PC
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Dates
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Enumeration Date | 03/21/2013
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Last Update Date | 05/25/2013
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Provider Practice Location Address
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Address Line | 1205 LANGHORNE NEWTOWN RD ST. MARY MEDICAL BLDG, SUITE 406B
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City | LANGHORNE
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State | PA
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Zip | 19047-1219
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Country | US
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Telephone | 267-685-0785
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 LANGHORNE NEWTOWN RD ST MARY MEDICAL BUILDING, SUITE 406B
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City | LANGHORNE
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State | PA
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Zip | 19047-1219
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Country | US
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Telephone | 267-685-0785
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MANISHA D NAIK
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Credential | DO
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Telephone | 267-685-0785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | OS013402
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License Number State | PA
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