Andrea Marie Manis

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

526132 Issued in TN

Practice address

800 Irving Ave
Syracuse, NY 13210-2716

Phone

(315) 425-4400

NPI assigned

Aug 25, 2023

Last updated

Aug 25, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1770368128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11612A MULBERRY AVE",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136033250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIS",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "TN",
            "license": "526132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Mango, MD
• Amanda Marie Mangold
• Mary F Mangona, LMSW
• Jamie Ann Mangovski, P.A.
• Sonya Mangovski
• Fnu Mankirat Kaur
• Emily Manley, NP
• Joseph Manley, R.PH.
• Deborah J Mann, MD
• Brianna Delores Mae Manning, CRPA

• Radiologic Technologist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Radiologic Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.