Provider Demographics
NPI:1497410427
Name:MANUSZAK, EMMA LAVINIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:LAVINIA
Last Name:MANUSZAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 W UNIVERSITY DR APT 1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1881
Mailing Address - Country:US
Mailing Address - Phone:248-773-9430
Mailing Address - Fax:
Practice Address - Street 1:43200 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1707
Practice Address - Country:US
Practice Address - Phone:586-799-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704364723363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health