Active NPI
Nicole Manzare
- School Counselor
- Port Jervis, NY
National Provider Identifier
1740627140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 1402503
- Practice address
- 88 E Main St
Port Jervis, NY 12771-2109 - Phone
- (845) 858-2874
- NPI assigned
- May 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NY | ||
| School Counselor | 101YS0200X | 1402503 | NY | Primary |
Addresses
Primary practice location
88 E Main St
Port Jervis, NY 12771-2109
Mailing address
32A Osseo Park Rd
Monroe, NY 10950-4772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1402503 | NY | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1740627140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32A OSSEO PARK RD",
"city": "MONROE",
"state": "NY",
"postal_code": "109504772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 E MAIN ST",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127712109",
"telephone_number": "845-858-2874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZARE",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-27",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "NY",
"license": "1402503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.