Individual
POONAM MANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
(630) 631-1277
Mailing address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
272871
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
272871
AZ
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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