Manal Ismail Fallatah, RN, BSN, MSN.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

861133-01 Issued in NY

Practice address

531 Championship Dr
Victor, NY 14564-8810

Phone

(585) 200-0553

NPI assigned

Jun 12, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Manal Johnston Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1467136309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 CHAMPIONSHIP DR",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145648810",
            "telephone_number": "585-200-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 CHAMPIONSHIP DR",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145648810",
            "telephone_number": "585-200-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLATAH",
        "first_name": "MANAL",
        "middle_name": "ISMAIL",
        "name_prefix": "Ms.",
        "credential": "RN, BSN, MSN.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "861133-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANAL",
            "last_name": "JOHNSTON",
            "prefix": "MS.",
            "credential": "RN, BSN, MSN.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kelsey Rose Englerth, OTR/L
• Jennifer M Erb
• Tori Anne Errigo, OTR/L
• Jeffrey Eveland, L.M.H.C.
• Jennifer Louise Eveleigh, OTR/L
• Dolores Pfrengle Fanton, RPH
• Lynette M Farrell, B.S.
• Jayson Faynor, DPT
• Meghan Feasel
• Noelle Feller

• All providers in Victor, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.