Provider Demographics
NPI:1639459464
Name:MANLEY, ERIN (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MANLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 92ND ST
Mailing Address - Street 2:SUTIE BB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7516
Mailing Address - Country:US
Mailing Address - Phone:212-595-1705
Mailing Address - Fax:212-595-1706
Practice Address - Street 1:150 W 92ND ST
Practice Address - Street 2:SUTIE BB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7516
Practice Address - Country:US
Practice Address - Phone:212-595-1705
Practice Address - Fax:212-595-1706
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist