Provider Demographics
NPI:1770630329
Name:MANISTER, NANCY NEFF (DNS, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:NEFF
Last Name:MANISTER
Suffix:
Gender:F
Credentials:DNS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 WHITE PLAINS RD
Mailing Address - Street 2:MINUTE CLINIC
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2826
Mailing Address - Country:US
Mailing Address - Phone:914-337-5300
Mailing Address - Fax:
Practice Address - Street 1:375 WHITE PLAINS RD
Practice Address - Street 2:MINUTE CLINIC
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2826
Practice Address - Country:US
Practice Address - Phone:914-337-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7599695OtherGHI
NY02153708Medicaid
NY0E0251OtherBLUE CROSS BLUE SHIELD
NY3123620OtherAETNA HMO
NY5674037OtherAETNA
NY7599695OtherGHI