Provider Demographics
NPI:1477517464
Name:MANUBAY, NANCY (PA-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MANUBAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9348
Mailing Address - Country:US
Mailing Address - Phone:610-217-3745
Mailing Address - Fax:
Practice Address - Street 1:4400 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-8621
Practice Address - Country:US
Practice Address - Phone:610-670-2522
Practice Address - Fax:610-670-7736
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003451L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP27500Medicare UPIN