Provider Demographics
NPI:1386075679
Name:MANOS, YWCHARI
Entity type:Individual
Prefix:
First Name:YWCHARI
Middle Name:
Last Name:MANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3829 W CAVALIER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-1719
Mailing Address - Country:US
Mailing Address - Phone:602-919-5608
Mailing Address - Fax:
Practice Address - Street 1:3829 W CAVALIER DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-1719
Practice Address - Country:US
Practice Address - Phone:602-919-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor