Susan R Manea, M.D.

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

206304 Issued in MA

Practice address

40 2ND Ave
Waltham, MA 02451-1132

Phone

(781) 466-9555

Fax

(781) 487-2361

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053336958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 2ND AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511132",
            "telephone_number": "781-466-9555",
            "fax_number": "781-487-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 2ND AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511132",
            "telephone_number": "781-466-9555",
            "fax_number": "781-487-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEA",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "MA",
            "license": "206304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124541",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alaina Malpere
• Yelena Mamedova, M.S. CCC/SLP
• Monica Manandhar, MD
• Andrew Mancini, SLP
• Lisa Carolyn Mandelblatt
• Jillian Mangone, SLP
• Miranda Alicia Mangual, LCSW
• Brooke Mann
• Susan Mann, MS
• Ashima Mannan, NP

• Ph.D. Medical Genetics in Waltham, MA
• Providers in Waltham, MA by specialty
• Ph.D. Medical Genetics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.