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General NPI Number Information
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NPI Number | 1821300401
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Entity Type | Individual
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Provider Name | PRAJESH MANI GHIMIRE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 2 TOMMY LUTHER DR
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-6054
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Country | US
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Telephone | 518-581-0892
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Fax |
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Provider Business Mailing Address
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Address Line | 113 DEANNA CT
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City | NISKAYUNA
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State | NY
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Zip | 12309-1333
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Country | US
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Telephone | 518-330-2843
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2011-01067
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License Number State | NC
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