Provider Demographics
NPI:1174823470
Name:MCMANUS, BRITT
Entity Type:Individual
Prefix:
First Name:BRITT
Middle Name:
Last Name:MCMANUS
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 1:2023 COOK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:NY
Mailing Address - Zip Code:12019-2909
Mailing Address - Country:US
Mailing Address - Phone:518-330-4606
Mailing Address - Fax:
Practice Address - Street 1:961 RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:NY
Practice Address - Zip Code:12148-1123
Practice Address - Country:US
Practice Address - Phone:518-399-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015477-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist