Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Manju Koyakkattu Thomas

Individual provider Family Medicine Physician · NPI 1215554035

Manju Koyakkattu Thomas is a Nurse Practitioner in Bronx, New York. Qualified in 2019, 7 years ago. Practices with Montefiore Medical Center, a 2,796-clinician group. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2020
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Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 345568-01 (NY)

Record details

NPI number1215554035
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 26, 2020
Last updated in NPPESJune 26, 2020
Certification dateJune 26, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Montefiore Medical Center — 2796 clinicians
Accepts Medicare assignment Not indicated

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