Provider Demographics
NPI:1356821839
Name:MANZI, LAUREN (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MANZI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 BROADHOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-5002
Mailing Address - Country:US
Mailing Address - Phone:631-359-5911
Mailing Address - Fax:631-396-0865
Practice Address - Street 1:389 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-4062
Practice Address - Country:US
Practice Address - Phone:978-478-5050
Practice Address - Fax:978-478-5044
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist