Physician Compare National (NPI:1508011719)

HEALTHCARE PROVIDER: MANJULA BATHINI D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508011719
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406039528
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110328000717
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BATHINI
	Individual professional last name
Provider First Name	MANJULA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	22 -18 BROADWAY
	Group Practice or individual's line 1 address
City	FAIR LAWN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	074103016
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y