Provider Demographics
NPI:1962387761
Name:BAGALE, MANISHA
Entity type:Individual
Prefix:
First Name:MANISHA
Middle Name:
Last Name:BAGALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3861 LIMERICK AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1639
Mailing Address - Country:US
Mailing Address - Phone:667-310-9104
Mailing Address - Fax:
Practice Address - Street 1:3861 LIMERICK AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1639
Practice Address - Country:US
Practice Address - Phone:667-310-9104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH536925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse