Susan Nicole Manganaro, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

274505 Issued in NY

Practice address

Neurology Associates of Stony Brook Ufpc
Stony Brook University Hospital, HSC T12-020
Stony Brook, NY 11794-8121

Phone

(631) 444-2599

Fax

(631) 444-1474

NPI assigned

Jul 13, 2009

Last updated

Apr 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Associates in Obstetrics & Gynecology, University Faculty P

  • Obstetrics & Gynecology Physician
  • Stony Brook, NY
  • NPI 1538114723
  NPD (past)

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1720217672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEUROLOGY ASSOCIATES OF STONY BROOK UFPC",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL, HSC T12-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948121",
            "telephone_number": "631-444-2599",
            "fax_number": "631-444-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEUROLOGY ASSOCIATES OF STONY BROOK UFPC",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL, HSC T12-020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948121",
            "telephone_number": "631-444-2599",
            "fax_number": "631-444-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANARO",
        "first_name": "SUSAN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "274505",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "274505",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NY",
            "license": "274505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mammoth Optical (stony brook vision world)
• Linda Mamone
• Rachel Manci, MD
• Alyssa Joan Mancini, MD
• Violet Ann Mandracchia, MA CEAS LCSW
• Nicholas Rocco Mangano, MD, MS
• Kartik M Mani, M.D., PH.D
• Racheed Matthew Mani, MD
• Poornima Manikantan
• Seth Mankes, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Neurology with Special Qualifications in Child Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.