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NPI Code Detail

MEDICARE: DR. MANOJ THANGAM M.D.

MEDICARE: DR. MANOJ THANGAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianQ9059TX
2207R00000XInternal Medicine Physician308470NY
3207RC0000XCardiovascular Disease Physician308470NY
4207RI0011XInterventional Cardiology PhysicianQ9059TX

General Provider Information

NPI Number : 1205270204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANOJ THANGAM M.D.
Provider Business Mailing Address
First Line : 630 W 168TH ST # 4
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3725
Country : US
Telephone Number : 212-305-7060
Fax Number :
Provider Business Practice Location Address
First Line : 1004 W 32ND ST STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1917
Country : US
Telephone Number : 512-324-3440
Fax Number : 512-406-6513
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2013
Last Update Date : 05/30/2025

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Directions to “ DR. MANOJ THANGAM M.D.” Practice Location

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