Individual
NICHOLAS MICHAEL MANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
252 FOREST ST, PEABODY, MA 01960-3919
(978) 535-0514
Mailing address
252 FOREST ST, PEABODY, MA 01960-3919
(978) 984-5285
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17627
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17627
—
MA
Enumeration date
02/02/2021
Last updated
02/02/2021
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