Basic Information
| Provider Information | |||||||||
| NPI: | 1609186337 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GURUNG | ||||||||
| FirstName: | MANOJ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27 CEDAR POND DR | ||||||||
| Address2: | APT-7 | ||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028866638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857551241 | ||||||||
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| Practice Location | |||||||||
| Address1: | 455 TOLL GATE RD | ||||||||
| Address2: | KENT HOSPITAL | ||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028862759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017377000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2010 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD14351 | RI | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD14351 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.