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General NPI Number Information
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NPI Number | 1679791651
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Entity Type | Individual
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Provider Name | EGESTA MANI MD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 150 ROUTE 52
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City | CARMEL
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State | NY
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Zip | 10512
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Country | US
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Telephone | 845-228-2910
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Fax | 845-228-2914
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Provider Business Mailing Address
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Address Line | 50 DAYTON LN SUITE 202
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City | PEEKSKILL
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State | NY
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Zip | 10566-2859
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Country | US
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Telephone | 914-739-0087
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Fax | 914-737-1714
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 250339
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License Number State | NY
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