Healthcare Provider Details

I. General information

NPI: 1477517464
Provider Name (Legal Business Name): NANCY MANUBAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 PENN AVE
SINKING SPRING PA
19608-8621
US

IV. Provider business mailing address

137 GRANDE BLVD
SINKING SPRING PA
19608-9348
US

V. Phone/Fax

Practice location:
  • Phone: 610-670-2522
  • Fax: 610-670-7736
Mailing address:
  • Phone: 610-217-3745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA003451L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: