Provider Demographics
NPI:1518036854
Name:RICH, MANNY - (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:MANNY
Middle Name:-
Last Name:RICH
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 BROADWAY
Mailing Address - Street 2:305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3229
Mailing Address - Country:US
Mailing Address - Phone:212-966-7830
Mailing Address - Fax:212-219-0280
Practice Address - Street 1:588 BROADWAY
Practice Address - Street 2:305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3229
Practice Address - Country:US
Practice Address - Phone:212-966-7830
Practice Address - Fax:212-219-0280
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0025301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical