Most Relevant Information
Provider Data
| NPI Number: | 1003476250 |
| Provider Name: | MEENAKUMARI MANOHARAN |
| Entity Type: | Individual |
| Taxonomy Code: | 208D00000X |
| Specialty: | General Practice |
| License Number: | 87682 |
Most Important Dates
| Enumeration Date: | 06/19/2019 |
| Last Updated: | 05/05/2021 |
Provider Practice Location
801 OSTRUM ST
FOUNTAIN HILL
PA
180151000
Practice Location Phone/Fax
| Phone: | 4845267035 |
| Fax: | 4845267040 |
Provider Mailing Location
801 OSTRUM ST
FOUNTAIN HILL
PA
180151000
Provider Mailing Phone/Fax
| Phone: | 4845267035 |
| Fax: | 4845267040 |