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General NPI Number Information
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NPI Number | 1699470153
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Entity Type | Organization
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Legal Business Name | LUCIAN MIRON MANU MD PSYCHIATRY PC
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 190 FROEHLICH FARM BLVD
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City | WOODBURY
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State | NY
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Zip | 11797-2905
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Country | US
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Telephone | 516-808-0888
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Fax | 631-350-0286
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Provider Business Mailing Address
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Address Line | 101 DEER RUN
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1968
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Country | US
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Telephone | 516-353-1705
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISA COTTONE
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Credential |
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Telephone | 516-808-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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