Provider Demographics
NPI:1619678778
Name:MANZANET, JARAN DAVID (MSW)
Entity Type:Individual
Prefix:
First Name:JARAN
Middle Name:DAVID
Last Name:MANZANET
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 THIRD AVENUE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455
Mailing Address - Country:US
Mailing Address - Phone:718-520-8000
Mailing Address - Fax:
Practice Address - Street 1:2825 THIRD AVENUE
Practice Address - Street 2:SUITE 402
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker