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General NPI Number Information
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NPI Number | 1538336466
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Entity Type | Organization
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Legal Business Name | MANI MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 1600 W GIRARD AVE 2ND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19130-1615
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Country | US
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Telephone | 215-787-9503
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Fax | 215-787-9164
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Provider Business Mailing Address
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Address Line | 204 TREMAIN RD
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City | BENSALEM
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State | PA
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Zip | 19020-1642
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Country | US
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Telephone | 608-312-1097
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Fax |
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Authorized Official
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Title or Position | GASTROENTEROLOGIST
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Name | DR. ATIA S HASHIM
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Credential | M.D.
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Telephone | 608-312-1097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD072873L
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License Number State | PA
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