Provider Demographics
NPI:1548406929
Name:MCMANUS, BRIDGETTE MARIE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:MARIE
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 FERNDALE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-1505
Mailing Address - Country:US
Mailing Address - Phone:607-723-6700
Mailing Address - Fax:
Practice Address - Street 1:322 FERNDALE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1505
Practice Address - Country:US
Practice Address - Phone:607-723-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist