Provider Demographics
NPI:1992522296
Name:GARCIA TORRES, MANJOLLYS (LPN)
Entity type:Individual
Prefix:
First Name:MANJOLLYS
Middle Name:
Last Name:GARCIA TORRES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 UNION ST APT 1L
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4124
Mailing Address - Country:US
Mailing Address - Phone:413-930-0083
Mailing Address - Fax:
Practice Address - Street 1:705 UNION ST APT 1L
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4124
Practice Address - Country:US
Practice Address - Phone:413-930-0083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN1000981164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse