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General NPI Number Information
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NPI Number | 1992727200
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Entity Type | Individual
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Provider Name | VIVEKANAND MANOCHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 7423 S MASON MONTGOMERY ROAD
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City | MASON
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State | OH
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Zip | 45040
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Country | US
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Telephone | 513-354-3700
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Fax | 513-754-2014
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Provider Business Mailing Address
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Address Line | 6480 HARRISON AVE STE 201
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City | CINCINNATI
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State | OH
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Zip | 45247-7961
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Country | US
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Telephone | 513-354-3700
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Fax | 513-354-3705
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35-087792
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License Number State | OH
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