MEDICARE: DR. MANJUL ASTHANA PH.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
1	103T00000X	Psychologist	B1-0000113	DE

General Provider Information

NPI Number	:	1982640041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANJUL ASTHANA PH.D.

Provider Business Mailing Address
First Line	:	113 JUPITER RD
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-3426
Country	:	US
Telephone Number	:	302-234-0214
Fax Number	:	302-234-6617

Provider Business Practice Location Address
First Line	:	C/O HARMONIOUS MIND, 240 N. JAMES ST
Second Line	:	STE 111
City	:	NEWPORT
State	:	DE
Zip	:	19804-0000
Country	:	US
Telephone Number	:	302-407-1585
Fax Number	:	302-295-6289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	07/08/2007

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