Individual
MS. JULIE MANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., GNP, PMHNP
Contact information
Practice address
2780 MIDDLE COUNTRY RD, SUITE 306, LAKE GROVE, NY 11755-2124
(631) 981-8300
(631) 981-8400
Mailing address
2539 PHILLIP CT, BELLMORE, NY 11710-4931
(516) 826-1654
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
340114
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401230
NY
Other
Enumeration date
09/23/2008
Last updated
10/02/2015
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