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General NPI Number Information
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NPI Number | 1710498779
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Entity Type | Organization
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Legal Business Name | MACMANUS THERAPY, OT, P.C.
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 444 W JERICHO TPKE
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City | HUNTINGTON
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State | NY
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Zip | 11743-6061
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Country | US
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Telephone | 516-729-1352
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Fax |
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Provider Business Mailing Address
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Address Line | 28 BRIARWOOD DR
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City | HUNTINGTON
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State | NY
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Zip | 11743-4138
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Country | US
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Telephone | 516-729-1352
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Fax | 631-659-3798
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | IAN MICHAEL MACMANUS
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Credential | OTR/L
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Telephone | 516-729-1352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 012234-1
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License Number State | NY
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