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General NPI Number Information
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NPI Number | 1306799838
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Entity Type | Individual
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Provider Name | NICOLE MANASSERO
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Gender | Female
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 820 FRANKLIN AVE BLDG SUITE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1502
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Country | US
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Telephone | 516-358-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 20 MIRIAM ST
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City | VALLEY STREAM
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State | NY
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Zip | 11581-1321
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Country | US
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Telephone | 516-754-4426
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 053029
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License Number State | NY
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