Healthcare Provider Details

I. General information

NPI: 1295978625
Provider Name (Legal Business Name): ERIN ELIZABETH MANNING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST DEPARTMENT OF NEUROLOGY
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

PO BOX 29234
NEW YORK NY
10087-9234
US

V. Phone/Fax

Practice location:
  • Phone: 646-714-6138
  • Fax: 212-249-9185
Mailing address:
  • Phone: 646-714-6138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number266012
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number266012
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: