Individual provider · Type 1 NPI
Mark Jesuitas Manansala
Nurse Practitioner · Syracuse, NY
Practice location
301 Prospect Ave
Syracuse, NY 13203
Mailing address
7770 Tirrell Hill Cir
Liverpool, NY 13090-2508
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 343488 (NY) |
| Registered Nurse | 163W00000X | 575973 (NY) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1437643566
Mark Jesuitas Manansala's National Provider Identifier is 1437643566, issued on Jun 21, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Syracuse, NY. The record was last updated on Aug 21, 2018.