Provider Demographics
NPI:1891900510
Name:MANNING, LYNN (RN, LP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:RN, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W 12TH ST
Mailing Address - Street 2:# 16D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8275
Mailing Address - Country:US
Mailing Address - Phone:212-255-8236
Mailing Address - Fax:212-255-9437
Practice Address - Street 1:175 W 12TH ST
Practice Address - Street 2:# 16D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8275
Practice Address - Country:US
Practice Address - Phone:212-255-8236
Practice Address - Fax:212-255-9437
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000052102L00000X
NY137259364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health