Provider Demographics
NPI:1417951229
Name:MANNING, PHILIP J (MSCPHARM, RPH)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:MANNING
Suffix:
Gender:M
Credentials:MSCPHARM, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 QUARRY LN
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1030
Mailing Address - Country:US
Mailing Address - Phone:914-591-8977
Mailing Address - Fax:
Practice Address - Street 1:2 QUARRY LN
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1030
Practice Address - Country:US
Practice Address - Phone:914-591-8977
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist