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NPI Code Detail

MEDICARE: DR. SHIBINATH VELUTHA MANNIL MD

MEDICARE:  DR. SHIBINATH  VELUTHA MANNIL  MD
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
1207L00000XAnesthesiology PhysicianE-17561AR

General Provider Information

NPI Number : 1437824851
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIBINATH VELUTHA MANNIL MD
Provider Business Mailing Address
First Line : 1 CHILDRENS WAY # 653
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72202-3500
Country : US
Telephone Number : 501-364-1100
Fax Number : 501-364-4082
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 718-920-4383
Fax Number : 718-653-2367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 03/19/2024

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Directions to “ DR. SHIBINATH VELUTHA MANNIL MD” Practice Location

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