| Dr Manisha Kotay, MD | |
|
11958 W Broad St, Henrico, VA 23233-1007 | |
| (804) 828-9350 | |
| (804) 807-7949 |
| Full Name | Dr Manisha Kotay |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 11958 W Broad St, Henrico, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477131696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101289711 (Virginia) | Primary |
| 207W00000X | Ophthalmology | ME172896 (Florida) | Secondary |
| Entity Name | Mayo Clinic Jacksonville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790772317 PECOS PAC ID: 5698689297 Enrollment ID: O20031118000388 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Manisha Kotay, MD Po Box 780125, Philadelphia, PA 19178-0125 Ph: (804) 922-4844 | Dr Manisha Kotay, MD 11958 W Broad St, Henrico, VA 23233-1007 Ph: (804) 828-9350 |
Lauren Connelly, PMHNP-BC Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 10431 Patterson Ave, Henrico, VA 23238 Phone: 804-532-5147 Fax: 804-369-8818 |
Ryan Michael Rall, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2101 E Parham Rd Ste 102, Henrico, VA 23228 Phone: 804-799-9292 |
Cheryl Huber, PMHNP-BC Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2101 E Parham Rd Ste 102, Henrico, VA 23228 Phone: 804-799-9292 |
Soundarya Nagaraja Gowda, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 7607 Forest Ave Ste 300, Henrico, VA 23229 Phone: 804-288-2742 Fax: 804-288-9053 |
Dr. Ryan Canissario, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 11958 W Broad St, Henrico, VA 23233 Phone: 804-828-9350 |
Dr. Scott Robert Haines, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 11958 W Broad St, Henrico, VA 23233 Phone: 804-360-4669 Fax: 804-364-6697 |
Dr. Anthony Demetrios Julius, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 7607 Forest Ave Ste 300, Henrico, VA 23229 Phone: 804-288-2742 Fax: 804-288-9053 |