Provider Demographics
NPI:1013005065
Name:SY, MANUEL C (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:C
Last Name:SY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:139 CENTRE STREET
Mailing Address - Street 2:SUITE 618
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4556
Mailing Address - Country:US
Mailing Address - Phone:212-274-8088
Mailing Address - Fax:212-625-9881
Practice Address - Street 1:139 CENTRE STREET
Practice Address - Street 2:SUITE 618
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4556
Practice Address - Country:US
Practice Address - Phone:212-274-8088
Practice Address - Fax:212-625-9881
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY132490207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247241Medicaid
NYC08553Medicare UPIN
NY00247241Medicaid