Provider Demographics
NPI:1619163607
Name:MANU VACHHANI MD
Entity type:Organization
Organization Name:MANU VACHHANI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:MANU
Authorized Official - Middle Name:
Authorized Official - Last Name:VACHHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-253-1994
Mailing Address - Street 1:3729 EASTON NAZARETH HWY
Mailing Address - Street 2:STE 101
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8344
Mailing Address - Country:US
Mailing Address - Phone:610-253-1994
Mailing Address - Fax:610-253-8184
Practice Address - Street 1:3729 EASTON NAZARETH HWY
Practice Address - Street 2:STE 101
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8344
Practice Address - Country:US
Practice Address - Phone:610-253-1994
Practice Address - Fax:610-253-8184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA705393Medicare PIN