Provider Demographics
NPI:1811054190
Name:MANNION, NANCY ELLEN
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELLEN
Last Name:MANNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ELLEN
Other - Last Name:MANNION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:187 HEMPSTEAD AVE
Mailing Address - Street 2:187 HEMPSTEAD AVE.
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2906
Mailing Address - Country:US
Mailing Address - Phone:516-536-0399
Mailing Address - Fax:516-536-0399
Practice Address - Street 1:187 HEMPSTEAD AVE
Practice Address - Street 2:187 HEMPSTEAD AVE.
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2906
Practice Address - Country:US
Practice Address - Phone:516-536-0399
Practice Address - Fax:516-536-0399
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7039103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist