Provider Demographics
NPI:1912382342
Name:MCMANUS, ANDREA PITTORE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:PITTORE
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:PITTORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:18 BIGELOW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1741
Mailing Address - Country:US
Mailing Address - Phone:508-989-4535
Mailing Address - Fax:
Practice Address - Street 1:36 N BEDFORD ST
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1186
Practice Address - Country:US
Practice Address - Phone:508-690-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse