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NPI Code Detail

MEDICARE: DR. MYRL RAY STEPHEN MANLEY M.D.

MEDICARE: DR. MYRL RAY STEPHEN MANLEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician146130NY

General Provider Information

NPI Number : 1427249986
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MYRL RAY STEPHEN MANLEY M.D.
Provider Business Mailing Address
First Line : 95 PIERREPONT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-2704
Country : US
Telephone Number : 718-875-8937
Fax Number : 718-625-1744
Provider Business Practice Location Address
First Line : 95 PIERREPONT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-2704
Country : US
Telephone Number : 718-875-8937
Fax Number : 718-625-1744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2007
Last Update Date : 08/08/2007

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