Individual
ANGELA MANJGALADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 FISHERS STATION DR STE 117, VICTOR, NY 14564-9784
(585) 337-0992
(585) 337-0998
Mailing address
600 FISHERS STATION DR STE 117, VICTOR, NY 14564-9784
(585) 337-0992
(585) 337-0998
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
001782
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402705
NY
Other
Enumeration date
02/12/2019
Last updated
02/01/2023
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