Provider Demographics
NPI:1073293429
Name:MANONG, PHOEBE CATES
Entity Type:Individual
Prefix:
First Name:PHOEBE CATES
Middle Name:
Last Name:MANONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 RIVERS EDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1163
Mailing Address - Country:US
Mailing Address - Phone:646-766-4484
Mailing Address - Fax:
Practice Address - Street 1:102 RIVERS EDGE RD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1163
Practice Address - Country:US
Practice Address - Phone:646-766-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY881918163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health