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NPI Code Detail

MEDICARE: NGODA P MANONGI MD

MEDICARE: NGODA P MANONGI 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
1208M00000XHospitalist Physician319453NY
2207RC0000XCardiovascular Disease Physician319453NY

General Provider Information

NPI Number : 1871150532
Entity Type Code : Individual
Provider Name (Legal Business Name) : NGODA P MANONGI MD
Provider Business Mailing Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-670-1572
Fax Number : 718-670-1864
Provider Business Practice Location Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-670-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2019
Last Update Date : 06/03/2026

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