MANIKYAM MUTYALA (NPI# 1326068198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326068198 |
| Entity Type | Individual |
| Full Name | MANIKYAM MUTYALA |
| Credential | M.D |
| Practice Address |
276 85th Ave Floral Park NY 11001-1205 |
| Practice Telephone | 5163581674 |
| Mailing Telephone | 5163581674 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 229717-1 | NY | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
229717-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02559171 | 05 |
| Street Address |
276 85TH AVE |
| City | FLORAL PARK |
| State | NY |
| Zip Code | 11001-1205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373104 | Justin Wooley | Nurse Anesthetist, Certified Registered | 11520 Base Naval, Cadiz, ANDALUCIA 11001 | 2020-07-09 |
| 1912429374 | Runicka Singh | Counselor | 258-20 86th Ave, Floral Park, NY 11001 | 2017-07-07 |
| 1104346345 | Alliance Medical Solutions, Inc. | Spec/Tech, Health Info | 275 Jericho Tpke Ste 202, Floral Park, NY 11001 | 2017-06-20 |
| 1700311982 | Marilyn K Esthappan | Dentist | 24828 Jericho Tpke, Floral Park, NY 11001 | 2017-04-26 |
| 1457883183 | Gaukhar Omargaliyeva | Case Manager/Care Coordinator | 249-02 Jericho Turnpike, Suite 207, Floral Park, NY 11001 | 2017-03-31 |
| 1891161022 | Angela Murphy | Speech-Language Pathologist | 176 Aspen St., Floral Park, NY 11001 | 2015-08-11 |
| 1225452428 | Dennise Laboy | Social Worker | 11-43 47th Avenue, Long Island City, NY 11001 | 2014-02-07 |
| 1811250434 | Andrea Dilorenzo | Specialist | 91 Sprue Avenue, Floral Park, NY 11001 | 2012-06-19 |
| 1558632760 | Elaine Rachel Arnold | Speech-Language Pathologist | 500 Tulip Avenue, Floral Park, NY 11001 | 2012-01-19 |
| 1639446859 | Maureen Vetter Vetter-russell | Social Worker | 184 Aspen Street, Floral Park, NY 11001 | 2011-11-17 |
| Find all providers in zip 11001 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629081815 | Martin J Kaplitt | Surgery | 27110 Grand Central Pkwy, Apt 32e, Floral Park, NY 11005-1245 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003509 | Gs Medical, P.C. | Surgery | 377-b Pearsall Ave, Cedarhurst, NY 11516 | 2020-11-02 |
| 1073128971 | New York Vascular Group, Pllc | Surgery | 19 Laurel Ave Ste 102, Cornwall, NY 12518-1403 | 2020-09-09 |
| 1578190179 | Camilo Jose Martinez | Surgery | 23 S Howell Ave Ste H, Centereach, NY 11720-4445 | 2020-03-24 |
| 1407483399 | Interventional Medicine | Surgery | 1122a Coney Island Ave, Brooklyn, NY 11230-2307 | 2020-03-23 |
| 1487287975 | Syracuse Professional Medical Services of New York LLC | Surgery | 1101 Erie Blvd E Ste 201a, Syracuse, NY 13210-1144 | 2020-02-13 |
| 1457983181 | Syracuse Medical of New York LLC | Surgery | 1101 Erie Blvd E Ste 201b, Syracuse, NY 13210-1144 | 2020-02-11 |
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1528547312 | Norwood Professional Medical Services of New York LLC | Surgery | 3487-89 Jerome Ave, Ste A, Bronx, NY 10468 | 2018-08-13 |
| 1336628130 | Norwood Medical of New York LLC | Surgery | 3487-89 Jerome Ave, Ste B, Bronx, NY 10468 | 2018-08-13 |
| 1003393299 | Bushwick Professional Medical Services of New York LLC | Surgery | 441 Knickerbocker Ave Ste A, Brooklyn, NY 11237-4508 | 2018-07-20 |
| Find all providers with the same taxonomy | ||||
| City | FLORAL PARK |
| Zip Code | 11001 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.