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General NPI Number Information
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NPI Number | 1952047581
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Entity Type | Individual
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Provider Name | KRISTY MANOOKIAN RN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 21 GREGLAWN DR
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City | CLIFTON
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State | NJ
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Zip | 07013-2504
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Country | US
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Telephone | 862-571-0456
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4136 495 ALLWOOD RD.
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City | CLIFTON
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State | NJ
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Zip | 07012-9998
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Country | US
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Telephone | 862-571-0456
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 26NP05903500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR24924700
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License Number State | NJ
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