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General NPI Number Information
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NPI Number | 1578919858
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Entity Type | Individual
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Provider Name | JAMIE ROSEN MANNING
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Gender | Female
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 1056 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0112
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Country | US
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Telephone | 917-757-8747
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Fax |
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Provider Business Mailing Address
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Address Line | 875 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10065-4952
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Country | US
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Telephone | 212-288-3200
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 304669
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License Number State | NY
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