MEDICARE: NANCY MANUBAY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	MA003451L	PA

General Provider Information

NPI Number	:	1477517464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY MANUBAY PA-C

Provider Business Mailing Address
First Line	:	137 GRANDE BLVD
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-9348
Country	:	US
Telephone Number	:	610-217-3745
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 PENN AVE
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-8621
Country	:	US
Telephone Number	:	610-670-2522
Fax Number	:	610-670-7736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	11/18/2021

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