Mutyala, Manikyam
Mutyala, Manikyam is an individual health care provider with primary practice located at 276 85Th Ave , Floral Park NY 11001-1205. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Mutyala, Manikyam can be contacted via phone (516) 358-1674.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 229717-1 | New York |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 229717-1 | New York |
Profile Details
| NPI number | 1326068198 |
|---|---|
| LBN Legal business name | Mutyala, Manikyam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Oct 17th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326068198 | NPPES |
| New York | MEDICAID | 02559171 |
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