Provider Demographics
NPI:1548047806
Name:MANCHIKANTI, ANUSHA
Entity type:Individual
Prefix:
First Name:ANUSHA
Middle Name:
Last Name:MANCHIKANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MARINA POINTE DR
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-2071
Mailing Address - Country:US
Mailing Address - Phone:903-390-7448
Mailing Address - Fax:
Practice Address - Street 1:BOOKS & RATTLES INC.
Practice Address - Street 2:MIDDLE VILLAGE, 63-08 69TH PI
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379
Practice Address - Country:US
Practice Address - Phone:718-381-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist