Provider Demographics
NPI:1588183644
Name:MANUEL-EBANKS, AISHAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AISHAH
Middle Name:
Last Name:MANUEL-EBANKS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:AISHAH
Other - Middle Name:
Other - Last Name:MANUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 STRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 QUIMBY ST STE 6
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-5106
Practice Address - Country:US
Practice Address - Phone:973-495-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program