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General NPI Number Information
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NPI Number | 1114899218
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Entity Type | Individual
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Provider Name | WYNCHELLE MANALILI OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 49 W 24TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10010-3570
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Country | US
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Telephone | 917-525-4932
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 QUEENS PLZ N APT 18G
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-4039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 030583
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License Number State | NY
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