Individual
MANUEL CIFUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
646 WILLOWBROOK RD, STATEN ISLAND, NY 10314-6826
(786) 608-3233
Mailing address
646 WILLOWBROOK RD, STATEN ISLAND, NY 10314-6826
(786) 608-3233
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
742550-1
NY
363LF0000X
Family Nurse Practitioner
349509
NY
Other
Enumeration date
09/28/2019
Last updated
06/19/2025
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