Provider Demographics
NPI:1740750348
Name:MANFREADY, MICHAEL (LSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MANFREADY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PETUNIA DR APT 2K
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3731
Mailing Address - Country:US
Mailing Address - Phone:732-245-0872
Mailing Address - Fax:
Practice Address - Street 1:9 PETUNIA DR APT 2K
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3731
Practice Address - Country:US
Practice Address - Phone:732-245-0872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker