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General NPI Number Information
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NPI Number | 1689592859
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Entity Type | Individual
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Provider Name | MANASA MAYUKHA HANUMANTHU M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 300 BROOKLINE AVENUE BETH ISRAEL DEACONESS MEDICAL
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City | BOSTON
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State | MA
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Zip | 02215
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Country | US
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Telephone | 617-667-3524
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Fax |
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Provider Business Mailing Address
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Address Line | PLOT-34 8-228/A BHASKAR NAGER COLONY CHINNABONDILI PURA
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City | SRIKAKULAM
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State | ANDHRA PREDESH
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Zip | 532001
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Country | IN
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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